Iranian Red Crescent Medical Journal Iranian Red Crescent Medical Journal Iran Red Crescent Med J http://www.ircmj.com 2074-1804 2074-1812 10.5812/ircmj en jalali 2017 6 27 gregorian 2017 6 27 16 5
en 10.5812/ircmj.11772 Perinatal Outcome After Diagnosis of Oligohydramnious at Term Perinatal Outcome After Diagnosis of Oligohydramnious at Term research-article research-article Results

Mode of delivery, NICU admission neonatal death and induction of labor. Oligohydramnious is associated with a high rate of pregnancy complications and increased perinatal morbidity and mortality. Women with oligohydramnious usually have low-birth babies.

Conclusion

However, we can expect a safe and good outcome for pregnant women with oligohydramnious, should proper fetal surveillance and regular antenatal care visits be prepared.

Materials and Methods

The study was conducted at Amiralmomenin Hospital in Zabol for a period of 8 months from March 27, 2012 to November 05, 2012. It included 100 pregnant women diagnosed with the AFI of 5 cm or less at term. Control group included 300 pregnant women with AFI more than 8cm. Comparison was done between the two groups. Detailed data, regarding the fetal and pregnancy outcome, were recorded in terms of fetal weight, Apgar score at 1 and 5 min, using chi-square and p value.

Objectives

This study aimed to analyze the fetal outcome in low-risk pregnant women with oligohydramnious at term. This is a prospective, descriptive study.

Background

Oligohydramnious is a threatening condition to fetal health for which some treatment are available, and some are under evaluation. Oligohydramnious, is associated with increased pregnancy complications, congenital anomalies, and perinatal mortality. There is an inverse relationship between the amniotic fluid index (AFI), and the adverse perinatal outcome. Oligohydramnious is clinical condition characterized by amniotic fluid index (AFI) of 5 cm or less. Its incidence is 3-5% of all the pregnancies an accurate and reproducible method of determining abnormality in amniotic fluid volume (AFI) is sonographic assessment of amniotic fluid index (AFI). It often increases the risk of small-for gestational age (SGA) and also the incidence of cesarean section, meconium stained, low Apgar score and neonatal intensive care unit (NICU) admission.

Results

Mode of delivery, NICU admission neonatal death and induction of labor. Oligohydramnious is associated with a high rate of pregnancy complications and increased perinatal morbidity and mortality. Women with oligohydramnious usually have low-birth babies.

Conclusion

However, we can expect a safe and good outcome for pregnant women with oligohydramnious, should proper fetal surveillance and regular antenatal care visits be prepared.

Materials and Methods

The study was conducted at Amiralmomenin Hospital in Zabol for a period of 8 months from March 27, 2012 to November 05, 2012. It included 100 pregnant women diagnosed with the AFI of 5 cm or less at term. Control group included 300 pregnant women with AFI more than 8cm. Comparison was done between the two groups. Detailed data, regarding the fetal and pregnancy outcome, were recorded in terms of fetal weight, Apgar score at 1 and 5 min, using chi-square and p value.

Objectives

This study aimed to analyze the fetal outcome in low-risk pregnant women with oligohydramnious at term. This is a prospective, descriptive study.

Background

Oligohydramnious is a threatening condition to fetal health for which some treatment are available, and some are under evaluation. Oligohydramnious, is associated with increased pregnancy complications, congenital anomalies, and perinatal mortality. There is an inverse relationship between the amniotic fluid index (AFI), and the adverse perinatal outcome. Oligohydramnious is clinical condition characterized by amniotic fluid index (AFI) of 5 cm or less. Its incidence is 3-5% of all the pregnancies an accurate and reproducible method of determining abnormality in amniotic fluid volume (AFI) is sonographic assessment of amniotic fluid index (AFI). It often increases the risk of small-for gestational age (SGA) and also the incidence of cesarean section, meconium stained, low Apgar score and neonatal intensive care unit (NICU) admission.

Amniotic Fluid Index;Apgar Score;Birth Weight Amniotic Fluid Index;Apgar Score;Birth Weight http://www.ircmj.com/index.php?page=article&article_id=11772 Fateme Keikha Fateme Keikha Department of Obstetrics and Gynecology, Tehran University of Medical Sciences Tehran, Tehran, IR Iran Department of Obstetrics and Gynecology, Tehran University of Medical Sciences Tehran, Tehran, IR Iran Kolsoum Rezaie Kahkhaie Kolsoum Rezaie Kahkhaie Zabol Medicinal Plants Research Center, University of Medical Sciences, Zabol, IR Iran Zabol Medicinal Plants Research Center, University of Medical Sciences, Zabol, IR Iran Khadije Rezaie Keikhaie Khadije Rezaie Keikhaie Department of Obstetrics and Gynecology, Tehran University of Medical Sciences Tehran, Tehran, IR Iran; Department of Obstetrics and Gynecology, Tehran University of Medical Sciences Tehran, Tehran, IR Iran. Tel: +98-9158535428, Department of Obstetrics and Gynecology, Tehran University of Medical Sciences Tehran, Tehran, IR Iran; Department of Obstetrics and Gynecology, Tehran University of Medical Sciences Tehran, Tehran, IR Iran. Tel: +98-9158535428, Abdolghani Abdollahimohammad Abdolghani Abdollahimohammad Nursing and Midwifery School, Zabol Medical Sciences University, Zabol, IR Iran Nursing and Midwifery School, Zabol Medical Sciences University, Zabol, IR Iran Shahrbanoo Salehin Shahrbanoo Salehin Nursing and Midwifery School, Zabol Medical Sciences University, Zabol, IR Iran Nursing and Midwifery School, Zabol Medical Sciences University, Zabol, IR Iran
en 10.5812/ircmj.11698 Comparison of QT Dispersion With Left Ventricular Mass Index in Early Diagnosis of Cardiac Dysfunction in Patients With β-Thalassemia Major Comparison of QT Dispersion With Left Ventricular Mass Index in Early Diagnosis of Cardiac Dysfunction in Patients With β-Thalassemia Major research-article research-article Conclusions:

This study showed acceptable sensitivity and specificity of QTcd and QTd in comparison to LVMI; it seems that standard ECG can be used for early diagnosis of cardiac involvement in asymptomatic patients with thalassemia major.

Patients and Methods:

In a case-control study, 60 patients older than ten years of age with thalassemia major who received regular blood transfusion and iron chelators were selected as the case group and were compared with 60 healthy age- and sex-matched subjects. All patients had myocardial performance index (MPI) of more than 0.5 and MPI for controls was less than 0.5. Echocardiography and ECG were performed for both groups and data were analyzed using appropriate statistical tests.

Results:

The mean age of cases and controls were 16 ± 2.8 and 16.08 ± 3.01 years, respectively. Male to female ratio was 33:27 in case group and 31:29 in the control group. LVMI in the case group was greater than control group. QTd and QTcd were larger in case group than in control group. The sensitivity and specificity of LVM, LVMI, QTd, and QTcd were as follows: 88.3%, 77.1%; 86.7%, 80%; 93.8%, 80%; and 91.7%, 86.7%, respectively.

Background:

In electrocardiography (ECG), QT is the interval between the onset of Q wave to the end of the T wave. This interval may be a sign of changes in the ventricular structure in hematologic disorders such as thalassemia major.

Objectives:

The main goal of this study was to compare the diagnostic value of corrected QT dispersion (QTcd) and QT dispersion (QTd) with left ventricular mass (LVM) and left ventricular mass index (LVMI) as well as to determine their sensitivity and specificity in early detection of the cardiac involvement in patients with β-thalassemia major.

Conclusions:

This study showed acceptable sensitivity and specificity of QTcd and QTd in comparison to LVMI; it seems that standard ECG can be used for early diagnosis of cardiac involvement in asymptomatic patients with thalassemia major.

Patients and Methods:

In a case-control study, 60 patients older than ten years of age with thalassemia major who received regular blood transfusion and iron chelators were selected as the case group and were compared with 60 healthy age- and sex-matched subjects. All patients had myocardial performance index (MPI) of more than 0.5 and MPI for controls was less than 0.5. Echocardiography and ECG were performed for both groups and data were analyzed using appropriate statistical tests.

Results:

The mean age of cases and controls were 16 ± 2.8 and 16.08 ± 3.01 years, respectively. Male to female ratio was 33:27 in case group and 31:29 in the control group. LVMI in the case group was greater than control group. QTd and QTcd were larger in case group than in control group. The sensitivity and specificity of LVM, LVMI, QTd, and QTcd were as follows: 88.3%, 77.1%; 86.7%, 80%; 93.8%, 80%; and 91.7%, 86.7%, respectively.

Background:

In electrocardiography (ECG), QT is the interval between the onset of Q wave to the end of the T wave. This interval may be a sign of changes in the ventricular structure in hematologic disorders such as thalassemia major.

Objectives:

The main goal of this study was to compare the diagnostic value of corrected QT dispersion (QTcd) and QT dispersion (QTd) with left ventricular mass (LVM) and left ventricular mass index (LVMI) as well as to determine their sensitivity and specificity in early detection of the cardiac involvement in patients with β-thalassemia major.

Beta-Thalassemia;Cardiac involvement;Electrocardiography;Echocardiography Beta-Thalassemia;Cardiac involvement;Electrocardiography;Echocardiography http://www.ircmj.com/index.php?page=article&article_id=11698 Noor Mohammad Noori Noor Mohammad Noori Children and Adolescents’ Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran Children and Adolescents’ Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran Maziar Mahjoubifard Maziar Mahjoubifard Children and Adolescents’ Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran; Children and Adolescents’ Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-9151418089 Children and Adolescents’ Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran; Children and Adolescents’ Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-9151418089 Mehdi Mohammadi Mehdi Mohammadi Children and Adolescents’ Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran Children and Adolescents’ Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran Alireza Jahangiri Fard Alireza Jahangiri Fard Tracheal Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Tracheal Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Abdolhossein Abassi Abdolhossein Abassi Zahedan University of Medical Sciences, Zahedan, IR Iran Zahedan University of Medical Sciences, Zahedan, IR Iran Behrooz Farzanegan Behrooz Farzanegan Tracheal Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Tracheal Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.11573 Environmental Determinants of Cardiovascular Diseases Risk Factors: A Qualitative Directed Content Analysis Environmental Determinants of Cardiovascular Diseases Risk Factors: A Qualitative Directed Content Analysis research-article research-article Conclusions:

The environmental factors were barriers for doing healthy behaviors. These factors need to be considered to design health promotion interventions. Policymakers should not only focus on patients’ education but also should provide specific facilities to enhance economic, social and cultural status.

Results:

Lack of behaviors like stress control, healthy eating and physical activity were the roots of the risk factors for CVD. The environmental factor is one of the barriers for conducting these behaviors. The environmental barriers included of structural environment including “availability and accessibility of health resources”, “new skills”, and “law and policies” which are located in enabling category and social environment including “social support”, “motivation to comply” and “consequences of behavior” which are located in reinforcing category. The most barriers to performing health behaviors were often structural.

Patients and Methods:

This qualitative study conducted over six months in 2012 at Diabetes Units of Health Centers associated with Alborz University of Medical Sciences and Health Services which is located in Karaj, Iran. The data were collected based on individual semi-structured interviews with 50 patients and 12 healthcare providers. Data analysis was performed simultaneous with data collection using the content analysis directed method.

Background:

Cardiovascular diseases (CVDs) are the number one cause of death in the world. In most analyses of health problems, environment plays a significant and modifiable role in causing the problem either directly or indirectly through behavior.

Objectives:

This study aims to understand the patients and healthcare providers’ experiences about the environmental determinants of CVD risk factors based on the Precede Model.

Conclusions:

The environmental factors were barriers for doing healthy behaviors. These factors need to be considered to design health promotion interventions. Policymakers should not only focus on patients’ education but also should provide specific facilities to enhance economic, social and cultural status.

Results:

Lack of behaviors like stress control, healthy eating and physical activity were the roots of the risk factors for CVD. The environmental factor is one of the barriers for conducting these behaviors. The environmental barriers included of structural environment including “availability and accessibility of health resources”, “new skills”, and “law and policies” which are located in enabling category and social environment including “social support”, “motivation to comply” and “consequences of behavior” which are located in reinforcing category. The most barriers to performing health behaviors were often structural.

Patients and Methods:

This qualitative study conducted over six months in 2012 at Diabetes Units of Health Centers associated with Alborz University of Medical Sciences and Health Services which is located in Karaj, Iran. The data were collected based on individual semi-structured interviews with 50 patients and 12 healthcare providers. Data analysis was performed simultaneous with data collection using the content analysis directed method.

Background:

Cardiovascular diseases (CVDs) are the number one cause of death in the world. In most analyses of health problems, environment plays a significant and modifiable role in causing the problem either directly or indirectly through behavior.

Objectives:

This study aims to understand the patients and healthcare providers’ experiences about the environmental determinants of CVD risk factors based on the Precede Model.

Environment;Risk Factors;Cardiovascular;Qualitative Research;Precede Model Environment;Risk Factors;Cardiovascular;Qualitative Research;Precede Model http://www.ircmj.com/index.php?page=article&article_id=11573 Leila Sabzmakan Leila Sabzmakan Department of Health Education & Promotion, Alborz University of Medical Sciences, Karaj, IR Iran Department of Health Education & Promotion, Alborz University of Medical Sciences, Karaj, IR Iran Eesa Mohammadi Eesa Mohammadi Department of Nursing, Tarbiat Modares University, Tehran, IR Iran; Department of Nursing, Tarbiat Modares University, Tehran, IR Iran. Tel: +98-2634643590 Department of Nursing, Tarbiat Modares University, Tehran, IR Iran; Department of Nursing, Tarbiat Modares University, Tehran, IR Iran. Tel: +98-2634643590 Mohammad Ali Morowatisharifabad Mohammad Ali Morowatisharifabad Department of Health Education, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Department of Health Education, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Ahmad Afaghi Ahmad Afaghi Department of Nutritionist, Qazvin University of Medical Sciences, Qazvin, IR Iran Department of Nutritionist, Qazvin University of Medical Sciences, Qazvin, IR Iran Mohammad Hassan Naseri Mohammad Hassan Naseri Department of Surgery, Alborz University of Medical Sciences, Karaj, IR Iran; Department of Surgery, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Department of Surgery, Alborz University of Medical Sciences, Karaj, IR Iran; Department of Surgery, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Masoud Mirzaei Masoud Mirzaei Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
en 10.5812/ircmj.11423 Intraspinal Lipomas Without Associated Spinal Dysraphism Intraspinal Lipomas Without Associated Spinal Dysraphism case-report case-report Introduction:

The aim of this study was to report surgical strategies and clinical outcomes for thoraco-lumbar intradural lipomas. Intraspinal lipomas are rare congenital histologically benign neoplasms, which account for less than 1% of all spinal cord tumors. These tumors are most frequently found in the lumbosacral area as components of a dysraphic state, however, intramedullary lipomas are not associated with spina bifida or cutaneous malformations and have only been described as isolated cases among spinal lipomas, where the thoracolumbar region is rarely affected.

Case Presentation:

Three patients with thoracolumbar intradural lipomas were admitted to our clinic at different points of time. Partial resections and debulking of the tumors were achieved with the guidance of an operating microscope. We performed laminectomies or laminoplasties, for tumor resections.

Discussion:

Postoperatively, the patients demonstrated significant clinical improvements. In this manuscript we presented our surgical experiences for intraspinal lipomas.

Introduction:

The aim of this study was to report surgical strategies and clinical outcomes for thoraco-lumbar intradural lipomas. Intraspinal lipomas are rare congenital histologically benign neoplasms, which account for less than 1% of all spinal cord tumors. These tumors are most frequently found in the lumbosacral area as components of a dysraphic state, however, intramedullary lipomas are not associated with spina bifida or cutaneous malformations and have only been described as isolated cases among spinal lipomas, where the thoracolumbar region is rarely affected.

Case Presentation:

Three patients with thoracolumbar intradural lipomas were admitted to our clinic at different points of time. Partial resections and debulking of the tumors were achieved with the guidance of an operating microscope. We performed laminectomies or laminoplasties, for tumor resections.

Discussion:

Postoperatively, the patients demonstrated significant clinical improvements. In this manuscript we presented our surgical experiences for intraspinal lipomas.

Lipoma;Spinal Cord;Spinal Dysraphism;Diagnostic Techniques, Surgical Lipoma;Spinal Cord;Spinal Dysraphism;Diagnostic Techniques, Surgical http://www.ircmj.com/index.php?page=article&article_id=11423 Erhan Arslan Erhan Arslan Department of Neurosurgery, School of Medicine, Giresun University, Giresun, Turkey; Department of Neurosurgery, School of Medicine, Giresun University, Nizamiye Mah, Mumcular Sok. No: 1/1, PC: 28000, Giresun, Turkey. Tel: +90-4543101690, Fax: +90-4543101696 Department of Neurosurgery, School of Medicine, Giresun University, Giresun, Turkey; Department of Neurosurgery, School of Medicine, Giresun University, Nizamiye Mah, Mumcular Sok. No: 1/1, PC: 28000, Giresun, Turkey. Tel: +90-4543101690, Fax: +90-4543101696 Kayhan Kuzeyli Kayhan Kuzeyli Department of Neurosurgery, School of Medicine, Karadeniz Technical University, Trabzon, Turkey Department of Neurosurgery, School of Medicine, Karadeniz Technical University, Trabzon, Turkey Elif Acar Arslan Elif Acar Arslan Department of Pediatric Neurology, School of Medicine, Hacettepe University, Ankara, Turkey Department of Pediatric Neurology, School of Medicine, Hacettepe University, Ankara, Turkey
en 10.5812/ircmj.11324 The Ameliorative Effect of Zingiber officinale in Diabetic Nephropathy The Ameliorative Effect of <italic>Zingiber officinale</italic> in Diabetic Nephropathy letter letter Diabetic Nephropathies;Ginger;Renoprotection Diabetic Nephropathies;Ginger;Renoprotection http://www.ircmj.com/index.php?page=article&article_id=11324 Mahmoud Rafieian-Kopaei Mahmoud Rafieian-Kopaei Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Hamid Nasri Hamid Nasri Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, IR Iran; Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: +98-3112208081, Fax: +98-3112235043 Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, IR Iran; Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: +98-3112208081, Fax: +98-3112235043
en 10.5812/ircmj.11284 Eligibility Assessment for Intravenous Thrombolytic Therapy in Acute Ischemic Stroke Patients; Evaluating Barriers for Implementation Eligibility Assessment for Intravenous Thrombolytic Therapy in Acute Ischemic Stroke Patients; Evaluating Barriers for Implementation research-article research-article Conclusions:

The major barriers for thrombolytic therapy for patients with AIS in this setting were delays in the provision of in-hospital services, like initial patient assessment, CT scans or laboratory studies. These results were in contrast with previous reports.

Background:

Intravenous thrombolysis is an approved treatment method for patients with acute ischemic stroke (AIS) and is recommended by multiple guidelines. However, it seems that it is less frequently used in the developing countries compared to the developed countries.

Objectives:

The purpose of this study was to estimate the percentage of patients with AIS, eligible for intravenous thrombolytic therapy, at the main referral center in Northwest Iran and to determine the main barriers for implementation of this method.

Patients and Methods:

Over one year, 647 patients who were admitted to the emergency department and met the Cincinnati Stroke Scale were enrolled into the study. The center to which patients were admitted, is a tertiary university hospital that has the required infrastructure for thrombolytic therapy in AIS. Factors recorded were neurological examinations and time between onset of symptoms and hospital arrival, hospital arrival and performance of brain computed tomography (CT) scanning, and hospital arrival to complete the investigations. Patients eligible for intravenous thrombolytic therapy were identified according to the American Heart Association (AHA) guidelines.

Results:

Mean time interval between hospital arrival and completion of brain CT scanning was 91 minutes (range: 20–378 minutes) and mean time from hospital arrival to completion of investigations was 150 minutes (range: 30–540 minutes). A total of 159 (31.3%) patients arrived at hospital within 3 hours of the onset of symptoms (early enough for intravenous thrombolytic therapy). However, 81.7% (130/159) of these patients missed thrombolytic therapy due to delayed performance of brain CT scanning and laboratory tests and 38.3% (61/159) had contraindications. The remaining 16 patients (10% of those who arrived within 3 hours and 3.1% of all cases) were eligible for thrombolytic therapy.

Conclusions:

The major barriers for thrombolytic therapy for patients with AIS in this setting were delays in the provision of in-hospital services, like initial patient assessment, CT scans or laboratory studies. These results were in contrast with previous reports.

Background:

Intravenous thrombolysis is an approved treatment method for patients with acute ischemic stroke (AIS) and is recommended by multiple guidelines. However, it seems that it is less frequently used in the developing countries compared to the developed countries.

Objectives:

The purpose of this study was to estimate the percentage of patients with AIS, eligible for intravenous thrombolytic therapy, at the main referral center in Northwest Iran and to determine the main barriers for implementation of this method.

Patients and Methods:

Over one year, 647 patients who were admitted to the emergency department and met the Cincinnati Stroke Scale were enrolled into the study. The center to which patients were admitted, is a tertiary university hospital that has the required infrastructure for thrombolytic therapy in AIS. Factors recorded were neurological examinations and time between onset of symptoms and hospital arrival, hospital arrival and performance of brain computed tomography (CT) scanning, and hospital arrival to complete the investigations. Patients eligible for intravenous thrombolytic therapy were identified according to the American Heart Association (AHA) guidelines.

Results:

Mean time interval between hospital arrival and completion of brain CT scanning was 91 minutes (range: 20–378 minutes) and mean time from hospital arrival to completion of investigations was 150 minutes (range: 30–540 minutes). A total of 159 (31.3%) patients arrived at hospital within 3 hours of the onset of symptoms (early enough for intravenous thrombolytic therapy). However, 81.7% (130/159) of these patients missed thrombolytic therapy due to delayed performance of brain CT scanning and laboratory tests and 38.3% (61/159) had contraindications. The remaining 16 patients (10% of those who arrived within 3 hours and 3.1% of all cases) were eligible for thrombolytic therapy.

Stroke;Thrombolytic Therapy;Developing Country;Eligibility Determination Stroke;Thrombolytic Therapy;Developing Country;Eligibility Determination http://www.ircmj.com/index.php?page=article&article_id=11284 Hormoz Ayromlou Hormoz Ayromlou Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Hassan Soleimanpour Hassan Soleimanpour Department of Emergency, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Emergency, Tabriz University of Medical Sciences, Tabriz, IR Iran Mehdi Farhoudi Mehdi Farhoudi Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Aliakbar Taheraghdam Aliakbar Taheraghdam Elyar Sadeghi Hokmabadi Elyar Sadeghi Hokmabadi Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran; Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4113340730, Fax: +98-4113340730 Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran; Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4113340730, Fax: +98-4113340730 Rouzbeh Rajaei Ghafouri Rouzbeh Rajaei Ghafouri Department of Emergency, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Emergency, Tabriz University of Medical Sciences, Tabriz, IR Iran Mehdi Najafi Nashali Mehdi Najafi Nashali Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Ehsan Sharifipour Ehsan Sharifipour Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Somayeh Mostafaei Somayeh Mostafaei Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Davar Altafi Davar Altafi Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran Department of Neurology, Tabriz University of Medical Sciences, Tabriz, IR Iran
en 10.5812/ircmj.10916 Antibiotic Susceptibility Patterns and Molecular Epidemiology of Metallo-β-Lactamase Producing Pseudomonas Aeruginosa Strains Isolated From Burn Patients Antibiotic Susceptibility Patterns and Molecular Epidemiology of Metallo-β-Lactamase Producing Pseudomonas Aeruginosa Strains Isolated From Burn Patients research-article research-article Background:

Failure in the treatment of burn patients infected with Pseudomonas aeruginosa could happen as a result of the acquisition of antibiotic resistance, including carbapenems.

Objectives:

The aim of the present study was to investigate the phenotypic and genotypic characteristics of the Pseudomonas aeruginosa strains, isolated from burn patients.

Patients and Methods:

During a 12 month period, in this cross-sectional study, two hundred seventy strains of Pseudomonas aeruginosa were isolated from the burn patients in Ghotbeddin Burn Hospital, Shiraz, Iran. Screening for the carbapenem resistance in the isolates was carried out by the E test method. Sensitivity patterns of metallo-β-lactamase (MβLs) producing strains of pseudomonas to eleven antibiotics were determined by the mentioned method. The epidemiological associations of these strains were determined by Pulsed-field gel electrophoresis (PFGE).

Results:

Of the 270 strains, 60 (22.2%) were resistant to imipenem and meropenem, classified as MβLs producing. MβLs producing strains of pseudomonas were completely resistant to five tested antibiotics while their sensitivities to the three most effective antibiotics including ceftazidime, amikacin and ciprofloxacin were 23.4%, 6.7 % and 1.7%, respectively. In PFGE, 37 patterns from the genome of Pseudomonas aeruginosa were observed. Majority of the strains (43; 71.6%) exhibited more than 80% similarity, based on the drawn dendrogram.

Conclusions:

According to the results, none of the tested antibiotics is safe to prescribe. As PFGE revealed, a limited number of Pseudomonas aeruginosa types are predominant in the hospitals which infect the burn patients.

Background:

Failure in the treatment of burn patients infected with Pseudomonas aeruginosa could happen as a result of the acquisition of antibiotic resistance, including carbapenems.

Objectives:

The aim of the present study was to investigate the phenotypic and genotypic characteristics of the Pseudomonas aeruginosa strains, isolated from burn patients.

Patients and Methods:

During a 12 month period, in this cross-sectional study, two hundred seventy strains of Pseudomonas aeruginosa were isolated from the burn patients in Ghotbeddin Burn Hospital, Shiraz, Iran. Screening for the carbapenem resistance in the isolates was carried out by the E test method. Sensitivity patterns of metallo-β-lactamase (MβLs) producing strains of pseudomonas to eleven antibiotics were determined by the mentioned method. The epidemiological associations of these strains were determined by Pulsed-field gel electrophoresis (PFGE).

Results:

Of the 270 strains, 60 (22.2%) were resistant to imipenem and meropenem, classified as MβLs producing. MβLs producing strains of pseudomonas were completely resistant to five tested antibiotics while their sensitivities to the three most effective antibiotics including ceftazidime, amikacin and ciprofloxacin were 23.4%, 6.7 % and 1.7%, respectively. In PFGE, 37 patterns from the genome of Pseudomonas aeruginosa were observed. Majority of the strains (43; 71.6%) exhibited more than 80% similarity, based on the drawn dendrogram.

Conclusions:

According to the results, none of the tested antibiotics is safe to prescribe. As PFGE revealed, a limited number of Pseudomonas aeruginosa types are predominant in the hospitals which infect the burn patients.

Beta-Lactamases; Imipenem; Meropenem; Pulsed Field Gel Electrophoresis Beta-Lactamases; Imipenem; Meropenem; Pulsed Field Gel Electrophoresis http://www.ircmj.com/index.php?page=article&article_id=10916 Aziz Japoni Aziz Japoni Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Mojtaba Anvarinejad Mojtaba Anvarinejad Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran; Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7116474264, Fax: +98-7116474303 Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran; Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7116474264, Fax: +98-7116474303 Shohreh Farshad Shohreh Farshad Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Giovanni M Giammanco Giovanni M Giammanco Department of Health Promotion Sciences, University of Palermo, Palermo, Italy Department of Health Promotion Sciences, University of Palermo, Palermo, Italy Noroddin Rafaatpour Noroddin Rafaatpour Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Ebrahim Alipour Ebrahim Alipour Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.5812/ircmj.10349 Investment on Education of Future Parents: the Best Measure for Enhancement of a Community Disaster Resiliency Investment on Education of Future Parents: the Best Measure for Enhancement of a Community Disaster Resiliency editorial editorial Residence Characteristics;Disasters;Resilience, Psychological Residence Characteristics;Disasters;Resilience, Psychological http://www.ircmj.com/index.php?page=article&article_id=10349 Behnaz Rastegar Far Behnaz Rastegar Far Disaster and Emergency Management Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Disaster and Emergency Management Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Mohammad Javad Moradian Mohammad Javad Moradian Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Disaster and Emeregncy Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, IR Iran; Poorsina Ave, Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9177001094 Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Disaster and Emeregncy Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, IR Iran; Poorsina Ave, Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9177001094 Ali Ardalan Ali Ardalan Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Disaster and Emeregncy Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, IR Iran; Harvrad Humanitarian Initiative, Harvard School of Public Health, Boston, USA Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Disaster and Emeregncy Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, IR Iran; Harvrad Humanitarian Initiative, Harvard School of Public Health, Boston, USA Javad Babaie Javad Babaie Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Disaster and Emeregncy Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, IR Iran Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Disaster and Emeregncy Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.10211 Mean Platelet Volume and Red Cell Distribution Width as a Diagnostic Marker in Acute Appendicitis Mean Platelet Volume and Red Cell Distribution Width as a Diagnostic Marker in Acute Appendicitis research-article research-article Background:

Acute appendicitis (AA) is one of the most common causes of emergent surgeries. Many methods are used for its diagnosis.

Objectives:

This study was conducted to investigate the diagnostic value of MPV and RDW in acute appendicitis.

Patients and Methods:

This study was a retrospective multi-center cross sectional planned study. The study included 260 patients operated for AA and 158 patients as the control group. Groups were compared in terms of MPV, RDW, white blood cell count (WBC), neutrophil predominance (NP) and platelet count (PC).

Results:

MPV was significantly lower in AA group, compared to the control group (P < 0.001). The best cut-off level for MVP in AA was ≤ 7.3 fL and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy ratio were 45%, 89.2%, 87.3%, 49.6% and 61.7%, respectively. There was no significant difference between the two groups in terms of RDW and platelet values.

Conclusions:

MPV is a routinely measured parameter in complete blood count (CBC) and requires no additional cost. It significantly decreased in AA, having a greater sensitivity and NPV when combined with WBC and NP.

Background:

Acute appendicitis (AA) is one of the most common causes of emergent surgeries. Many methods are used for its diagnosis.

Objectives:

This study was conducted to investigate the diagnostic value of MPV and RDW in acute appendicitis.

Patients and Methods:

This study was a retrospective multi-center cross sectional planned study. The study included 260 patients operated for AA and 158 patients as the control group. Groups were compared in terms of MPV, RDW, white blood cell count (WBC), neutrophil predominance (NP) and platelet count (PC).

Results:

MPV was significantly lower in AA group, compared to the control group (P < 0.001). The best cut-off level for MVP in AA was ≤ 7.3 fL and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy ratio were 45%, 89.2%, 87.3%, 49.6% and 61.7%, respectively. There was no significant difference between the two groups in terms of RDW and platelet values.

Conclusions:

MPV is a routinely measured parameter in complete blood count (CBC) and requires no additional cost. It significantly decreased in AA, having a greater sensitivity and NPV when combined with WBC and NP.

Appendicitis;Erythrocyte Indices;Blood Platelets Appendicitis;Erythrocyte Indices;Blood Platelets http://www.ircmj.com/index.php?page=article&article_id=10211 Ceren Sen Tanrikulu Ceren Sen Tanrikulu Department of Emergency Medicine, Ministry of Health, Erzurum Area Training and Research Hospital, Erzurum, Turkey Department of Emergency Medicine, Ministry of Health, Erzurum Area Training and Research Hospital, Erzurum, Turkey Yusuf Tanrikulu Yusuf Tanrikulu Department of General Surgery, Ministry of Health, Erzurum Area Training and Research Hospital, Erzurum, Turkey; Department of General Surgery, Ministry of Health, Erzurum Area Training and Research Hospital, Erzurum, Turkey. Tel: +90-5056579709, Fax: +90-4422325090 Department of General Surgery, Ministry of Health, Erzurum Area Training and Research Hospital, Erzurum, Turkey; Department of General Surgery, Ministry of Health, Erzurum Area Training and Research Hospital, Erzurum, Turkey. Tel: +90-5056579709, Fax: +90-4422325090 Mehmet Zafer Sabuncuoglu Mehmet Zafer Sabuncuoglu Department of General Surgery, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey Department of General Surgery, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey Mehmet Akif Karamercan Mehmet Akif Karamercan Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey Nezih Akkapulu Nezih Akkapulu Department of General Surgery, Ministry of Health, Mus State Hospital, Mus, Turkey Department of General Surgery, Ministry of Health, Mus State Hospital, Mus, Turkey Figen Coskun Figen Coskun Department of Chair of Emergency Medicine, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey Department of Chair of Emergency Medicine, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey
en 10.5812/ircmj.9066 Role of Occupational Stress and Burnout in Prevalence of Musculoskeletal Disorders Among Embassy Personnel of Foreign Countries in Iran Role of Occupational Stress and Burnout in Prevalence of Musculoskeletal Disorders Among Embassy Personnel of Foreign Countries in Iran research-article research-article Background:

Occupation is one of the major parts of our daily lives that might cause a great amount of stress. Stress and job burnout are linked together. The association between musculoskeletal disorders (MSD) and burnout syndrome as a psychosocial factor was investigated previously.

Objectives:

The aim of this study was to identify the role of occupational stress and burnout in musculoskeletal complaint among diplomatic employees of different embassies in Iran.

Materials and Methods:

In a cross-sectional study, we assessed 200 employees of the foreign countries embassies in Iran. The participants were selected randomly from all the embassy personnel. Study questionnaires were delivered to the participants and finally 161 questionnaires were returned to the researchers (response rate: 80.5%). An assessment of burnout and MSD were made using the Maslach Burnout Inventory (MBI) and Nordic questionnaires. The work place stress was measured by the work place stress questionnaire.

Results:

Mean occupational stress was significantly higher among embassy personnel with MSD than among the personnel without this syndrome during the preceding week (17.18 ± 3.42 and 16.06 ± 2.19, respectively; P = 0.02) and the preceding year (17.17 ± 3.11 and 16.74 ± 3.03, respectively; P < 0.01) to the study. Only smoking and occupational stress were identified as independent predictors of MSD among embassy personnel.

Conclusions:

It seems that association between musculoskeletal complaints and burnout syndrome was more complex than being attributed to only occupation stress. Further studies are recommended to determine other related factors to this association.

Background:

Occupation is one of the major parts of our daily lives that might cause a great amount of stress. Stress and job burnout are linked together. The association between musculoskeletal disorders (MSD) and burnout syndrome as a psychosocial factor was investigated previously.

Objectives:

The aim of this study was to identify the role of occupational stress and burnout in musculoskeletal complaint among diplomatic employees of different embassies in Iran.

Materials and Methods:

In a cross-sectional study, we assessed 200 employees of the foreign countries embassies in Iran. The participants were selected randomly from all the embassy personnel. Study questionnaires were delivered to the participants and finally 161 questionnaires were returned to the researchers (response rate: 80.5%). An assessment of burnout and MSD were made using the Maslach Burnout Inventory (MBI) and Nordic questionnaires. The work place stress was measured by the work place stress questionnaire.

Results:

Mean occupational stress was significantly higher among embassy personnel with MSD than among the personnel without this syndrome during the preceding week (17.18 ± 3.42 and 16.06 ± 2.19, respectively; P = 0.02) and the preceding year (17.17 ± 3.11 and 16.74 ± 3.03, respectively; P < 0.01) to the study. Only smoking and occupational stress were identified as independent predictors of MSD among embassy personnel.

Conclusions:

It seems that association between musculoskeletal complaints and burnout syndrome was more complex than being attributed to only occupation stress. Further studies are recommended to determine other related factors to this association.

Burnout, Professional;Musculoskeletal Diseases;Occupational Stress;Embassy Personnel Burnout, Professional;Musculoskeletal Diseases;Occupational Stress;Embassy Personnel http://www.ircmj.com/index.php?page=article&article_id=9066 Mashaallah Aghilinejad Mashaallah Aghilinejad Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran Zargham Sadeghi Zargham Sadeghi Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2188622682 Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2188622682 Amer Abdullah Amer Abdullah Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran Shima Sarebanha Shima Sarebanha Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran Amir Bahrami-Ahmadi Amir Bahrami-Ahmadi Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.8867 Effects of Recombinant Human Erythropoietin on Revascularization of Full Thickness Skin Grafts in Rat Effects of Recombinant Human Erythropoietin on Revascularization of Full Thickness Skin Grafts in Rat research-article research-article Background:

Autologous skin graft is frequently used in the field of plastic, and reconstructive surgery. The engraftment is dependent upon revascularization and angiogenesis, which can be regulated by different factors. In addition to its hematopoietic effects, erythropoietin is shown to positively affect the wound healing process.

Objectives:

We studied effects of human erythropoietin on revascularization of full thickness skin grafts in rat.

Materials and Methods:

Forty adult Albino male rats were selected for this study. Full thickness skin graft was performed for them, and the effects of systemic, and localized administration of erythropoietin on vascularization of the graft area were evaluated in four groups as following: inverse group underwent full thickness skin graft; in normal saline group normal saline was injected under the fascia of grafted area for seven days; systemic EPO group received systemic erythropoietin for seven days after the surgery; and in graft EPO group, erythropoietin was injected under the fascia of grafted area after full thickness skin grafting for seven days.

Results:

Forty adult Albino male rats (n = 40), with weights ranging from 356 to 469 g (mean 391.5 ± 29.6 g) were included. The vascular densities of central margins were significantly different between inverse group and graft EPO groups (P value = 0.01), and vascular density of central margins of normal saline group and graft EPO groups were significantly different too (P value = 0.04).

Conclusions:

EPO can stimulate angiogenesis which has an important role in wound healing. So, local administration of EPO seems to be beneficial in engraftment.

Background:

Autologous skin graft is frequently used in the field of plastic, and reconstructive surgery. The engraftment is dependent upon revascularization and angiogenesis, which can be regulated by different factors. In addition to its hematopoietic effects, erythropoietin is shown to positively affect the wound healing process.

Objectives:

We studied effects of human erythropoietin on revascularization of full thickness skin grafts in rat.

Materials and Methods:

Forty adult Albino male rats were selected for this study. Full thickness skin graft was performed for them, and the effects of systemic, and localized administration of erythropoietin on vascularization of the graft area were evaluated in four groups as following: inverse group underwent full thickness skin graft; in normal saline group normal saline was injected under the fascia of grafted area for seven days; systemic EPO group received systemic erythropoietin for seven days after the surgery; and in graft EPO group, erythropoietin was injected under the fascia of grafted area after full thickness skin grafting for seven days.

Results:

Forty adult Albino male rats (n = 40), with weights ranging from 356 to 469 g (mean 391.5 ± 29.6 g) were included. The vascular densities of central margins were significantly different between inverse group and graft EPO groups (P value = 0.01), and vascular density of central margins of normal saline group and graft EPO groups were significantly different too (P value = 0.04).

Conclusions:

EPO can stimulate angiogenesis which has an important role in wound healing. So, local administration of EPO seems to be beneficial in engraftment.

Erythropoietin;Neovascularization;Physiologic;Skin Transplantation Erythropoietin;Neovascularization;Physiologic;Skin Transplantation http://www.ircmj.com/index.php?page=article&article_id=8867 Mohammad Javad Fatemi Mohammad Javad Fatemi Department of Plastic and Reconstructive Surgery, Fatemeh Zahra Hospital, Tehran University of Medical Sciences, Tehran, IR Iran Department of Plastic and Reconstructive Surgery, Fatemeh Zahra Hospital, Tehran University of Medical Sciences, Tehran, IR Iran Abol Hasan Emami Abol Hasan Emami Department of Plastic and Reconstructive Surgery, Fatemeh Zahra Hospital, Tehran University of Medical Sciences, Tehran, IR Iran Department of Plastic and Reconstructive Surgery, Fatemeh Zahra Hospital, Tehran University of Medical Sciences, Tehran, IR Iran Sina Ghiasi Sina Ghiasi Shiraz Burn Research Centre, Division of Plastic Surgery, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran; Shiraz Burn Research Centre, Division of Plastic Surgery, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7118219640; Ext: 2, Fax: +98-7118217090 Shiraz Burn Research Centre, Division of Plastic Surgery, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran; Shiraz Burn Research Centre, Division of Plastic Surgery, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7118219640; Ext: 2, Fax: +98-7118217090 Seyed Morteza Seyed Jafari Seyed Morteza Seyed Jafari Shiraz Burn Research Centre, Division of Plastic Surgery, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Shiraz Burn Research Centre, Division of Plastic Surgery, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Ali Akbar Mohammadi Ali Akbar Mohammadi Shiraz Burn Research Centre, Division of Plastic Surgery, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Shiraz Burn Research Centre, Division of Plastic Surgery, Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.5812/ircmj.5186 Comparison of Problem-based Learning With Lecture-based Learning Comparison of Problem-based Learning With Lecture-based Learning research-article research-article Background:

Problem-based learning (PBL) is one of the most commonly used educational methods in medical schools of different countries. By working through this method, students think critically, generate ideas, and acquire the knowledge and skills required to become a doctor.

Objectives:

This study aimed to compare problem-based learning with lecture-based learning in the education of medical students.

Materials and Methods:

This crossover interventional study was conducted on 40 medical students in pediatric ward of Zanjan University of Medical Sciences. All of the students were enrolled in the study and divided into two groups by simple randomization. Then two topics in pediatric courses were chosen. One of the topics was presented as LBL for the first group and as PBL for the second group. The other topic was presented as PBL for the first group and as LBL for the second group.

Results:

The median score of the exam was higher in the intervention group compare to the control group for both topics. However, the difference was not statistically significant. Students preferred problem-based learning over lecture-based learning because of motivation boost, a higher quality of education, knowledge retention, class attractiveness, and practical use.

Conclusions:

Students’ knowledge was similar in both methods.

Background:

Problem-based learning (PBL) is one of the most commonly used educational methods in medical schools of different countries. By working through this method, students think critically, generate ideas, and acquire the knowledge and skills required to become a doctor.

Objectives:

This study aimed to compare problem-based learning with lecture-based learning in the education of medical students.

Materials and Methods:

This crossover interventional study was conducted on 40 medical students in pediatric ward of Zanjan University of Medical Sciences. All of the students were enrolled in the study and divided into two groups by simple randomization. Then two topics in pediatric courses were chosen. One of the topics was presented as LBL for the first group and as PBL for the second group. The other topic was presented as PBL for the first group and as LBL for the second group.

Results:

The median score of the exam was higher in the intervention group compare to the control group for both topics. However, the difference was not statistically significant. Students preferred problem-based learning over lecture-based learning because of motivation boost, a higher quality of education, knowledge retention, class attractiveness, and practical use.

Conclusions:

Students’ knowledge was similar in both methods.

Education;Lecture;Student;Medical;Problem-based Learning Education;Lecture;Student;Medical;Problem-based Learning http://www.ircmj.com/index.php?page=article&article_id=5186 Parisa Khoshnevisasl Parisa Khoshnevisasl Zanjan Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran; Zanjan Community Oriented Medical Education, Zanjan University of Medical Sciences, Zanjan, IR Iran Zanjan Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran; Zanjan Community Oriented Medical Education, Zanjan University of Medical Sciences, Zanjan, IR Iran Mansour Sadeghzadeh Mansour Sadeghzadeh Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran; Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran. Tel/Fax: +98-2414272737 Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran; Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran. Tel/Fax: +98-2414272737 Saeidah Mazloomzadeh Saeidah Mazloomzadeh Zanjan Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran; Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran Zanjan Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran; Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran Reza Hashemi Feshareki Reza Hashemi Feshareki Zanjan Community Oriented Medical Education, Zanjan University of Medical Sciences, Zanjan, IR Iran Zanjan Community Oriented Medical Education, Zanjan University of Medical Sciences, Zanjan, IR Iran Akefeh Ahmadiafshar Akefeh Ahmadiafshar Zanjan Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran; Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran Zanjan Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran; Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, IR Iran
en 10.5812/ircmj.11779 Forecasting Tuberculosis Incidence in Iran Using Box-Jenkins Models Forecasting Tuberculosis Incidence in Iran Using Box-Jenkins Models research-article research-article Background:

Predicting the incidence of tuberculosis (TB) plays an important role in planning health control strategies for the future, developing intervention programs and allocating resources.

Objectives:

The present longitudinal study estimated the incidence of tuberculosis in 2014 using Box-Jenkins methods.

Materials and Methods:

Monthly data of tuberculosis cases recorded in the surveillance system of Iran tuberculosis control program from 2005 till 2011 was used. Data was reviewed regarding normality, variance equality and stationary conditions. The parameters p, d and q and P, D and Q were determined, and different models were examined. Based on the lowest levels of AIC and BIC, the most suitable model was selected among the models whose overall adequacy was confirmed.

Conclusions:

Regarding the cyclic pattern of TB recorded cases, Box-Jenkins and SARIMA models are suitable for predicting its prevalence in future. Moreover, prediction results show an increasing trend of TB cases in Iran.

Results:

During 84 months, 63568 TB patients were recorded. The average was 756.8 (SD = 11.9) TB cases a month. SARIMA (0,1,1)(0,1,1)12 with the lowest level of AIC (12.78) was selected as the most adequate model for prediction. It was predicted that the total nationwide TB cases for 2014 will be about 16.75 per 100,000 people.

Background:

Predicting the incidence of tuberculosis (TB) plays an important role in planning health control strategies for the future, developing intervention programs and allocating resources.

Objectives:

The present longitudinal study estimated the incidence of tuberculosis in 2014 using Box-Jenkins methods.

Materials and Methods:

Monthly data of tuberculosis cases recorded in the surveillance system of Iran tuberculosis control program from 2005 till 2011 was used. Data was reviewed regarding normality, variance equality and stationary conditions. The parameters p, d and q and P, D and Q were determined, and different models were examined. Based on the lowest levels of AIC and BIC, the most suitable model was selected among the models whose overall adequacy was confirmed.

Conclusions:

Regarding the cyclic pattern of TB recorded cases, Box-Jenkins and SARIMA models are suitable for predicting its prevalence in future. Moreover, prediction results show an increasing trend of TB cases in Iran.

Results:

During 84 months, 63568 TB patients were recorded. The average was 756.8 (SD = 11.9) TB cases a month. SARIMA (0,1,1)(0,1,1)12 with the lowest level of AIC (12.78) was selected as the most adequate model for prediction. It was predicted that the total nationwide TB cases for 2014 will be about 16.75 per 100,000 people.

Tuberculosis;Forecasting;Iran;Hb Jenkins Tuberculosis;Forecasting;Iran;Hb Jenkins http://www.ircmj.com/index.php?page=article&article_id=11779 Mahmood Moosazadeh Mahmood Moosazadeh Department of Biostatistics and Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, IR Iran Department of Biostatistics and Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, IR Iran Mahshid Nasehi Mahshid Nasehi Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran Abbas Bahrampour Abbas Bahrampour Department of Biostatistics and Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, IR Iran Department of Biostatistics and Epidemiology, Faculty of Health, Kerman University of Medical Sciences, Kerman, IR Iran Narges Khanjani Narges Khanjani Neurology Research Center, Shafa Hospital, Kerman University of Medical Sciences, Kerman, IR Iran; Monash Centre for Occupational & Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Neurology Research Center, Shafa Hospital, Kerman University of Medical Sciences, Kerman, IR Iran. Tel/Fax: +98-3413205102 Neurology Research Center, Shafa Hospital, Kerman University of Medical Sciences, Kerman, IR Iran; Monash Centre for Occupational & Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Neurology Research Center, Shafa Hospital, Kerman University of Medical Sciences, Kerman, IR Iran. Tel/Fax: +98-3413205102 Saeed Sharafi Saeed Sharafi Center for Diseases Control and Prevention, Ministry of Health and Medical Education, Tehran, IR Iran Center for Diseases Control and Prevention, Ministry of Health and Medical Education, Tehran, IR Iran Shanaz Ahmadi Shanaz Ahmadi Center for Diseases Control and Prevention, Ministry of Health and Medical Education, Tehran, IR Iran Center for Diseases Control and Prevention, Ministry of Health and Medical Education, Tehran, IR Iran
en 10.5812/ircmj.11771 Perceived Concerns of Azeri Menopausal Women in Iran Perceived Concerns of Azeri Menopausal Women in Iran research-article research-article Results:

Participants’ concerns were classified into 4 main themes, including: inability, aging, isolation, and healthiness.

Conclusions:

Understanding these concerns might contribute to the enrichment of the existing literature by providing evidences from a different culture, assisting to design effective supportive strategies, planning training programs and appropriate infrastructures for women to improve their quality of life during the menopausal period.

Materials and Methods:

Phenomenological approach was used for analyzing the participants’ experiences and perceptions about menopause. Data were collected through 18 semi-structured in-depth interviews; carried out from February to July 2012. Participants were menopausal women aged between 46-57 years who experienced menopause no more than 4 years before the interview. All interviews were audio recorded and transcribed verbatim. Constant comparative analysis of the data was conducted using MAXQDA 10.

Objectives:

We aimed to explore self-experienced concerns of Iranian menopausal women residing in Tabriz.

Background:

Menopause is a complex biological phenomenon which is affected by socio-cultural and physiological factors. These factors may cause different experiences and concerns for menopausal women from different countries and even among women of diverse ethnic groups living in the same country. The signs and symptoms of menopause are exacerbated by the negative attitude of menopausal women and their deep concerns.

Results:

Participants’ concerns were classified into 4 main themes, including: inability, aging, isolation, and healthiness.

Conclusions:

Understanding these concerns might contribute to the enrichment of the existing literature by providing evidences from a different culture, assisting to design effective supportive strategies, planning training programs and appropriate infrastructures for women to improve their quality of life during the menopausal period.

Materials and Methods:

Phenomenological approach was used for analyzing the participants’ experiences and perceptions about menopause. Data were collected through 18 semi-structured in-depth interviews; carried out from February to July 2012. Participants were menopausal women aged between 46-57 years who experienced menopause no more than 4 years before the interview. All interviews were audio recorded and transcribed verbatim. Constant comparative analysis of the data was conducted using MAXQDA 10.

Objectives:

We aimed to explore self-experienced concerns of Iranian menopausal women residing in Tabriz.

Background:

Menopause is a complex biological phenomenon which is affected by socio-cultural and physiological factors. These factors may cause different experiences and concerns for menopausal women from different countries and even among women of diverse ethnic groups living in the same country. The signs and symptoms of menopause are exacerbated by the negative attitude of menopausal women and their deep concerns.

Menopause;Particulate Matter;Iran Menopause;Particulate Matter;Iran http://www.ircmj.com/index.php?page=article&article_id=11771 Sevil Hakimi Sevil Hakimi Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Masoumeh Simbar Masoumeh Simbar Safe Motherhood Research Center, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Safe Motherhood Research Center, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188202516, Fax: +98-2188202521 Safe Motherhood Research Center, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Safe Motherhood Research Center, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188202516, Fax: +98-2188202521 Fahimeh Ramezani Tehrani Fahimeh Ramezani Tehrani Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.13259 Self-directed Learning and Its Impact on Menopausal Symptoms Self-directed Learning and Its Impact on Menopausal Symptoms research-article research-article Conclusions:

Implementation of self-directed learning provides a useful strategy that should be included in health intervention and national surveillance programs in order to improve health and therapeutic compliance in postmenopausal women.

Results:

There were significant statistical differences between two groups regarding the age of subjects; age of menopause; economic, educational and employment status; number of dead and living children; BMI and vasomotor, physical, sexual and psycho-social postmenopausal symptoms. The implementation of Self-directed Learning (SDL) model leads to a significant statistical difference in scores of vasomotor symptoms (16.32 ± 5.92 to 13.26 ± 5.31), psychosocial symptoms (34.8 ± 11 to 27.18 ± 10.83), physical symptoms (75.02 ± 18.07 to 61.42 ± 15.49), sexual symptoms (15.36 ± 6.10 to 12.00 ± 4.97) and the overall score for quality of life (141.5 ± 41.09 to 113.86 ± 36.6) (P < 0.001). No significant changes were found in the QOL scores of the control group.

Patients and Methods:

The present single blind field study was conducted in Saadatmandi Health Center of Robat Karim (Iran, Southwest of Tehran Province) from August to December 2010. One handred and ten menopausal women were selected using convenience sampling method and then divided into two experimental (Self-directed Learning) and control groups of 55 each. Four manuals were developed to guide the women in the experimental group containing practical ways to treat menopausal symptoms. They were distributed among the participants for four weeks on a specific day. Menopausal Specific Quality of Life Questionnaire (MENQOL) was used to determine and compare quality of life scores of these women (before and three months after intervention sessions). The control group did not receive any intervention. Statistical analysis was performed by SPSS/16 software using Kolmogorov-Sminov, ANOVA, independent paired t test and Chi-square test.

Background:

One of the main criteria to verify the effectiveness of a health training program is to measure quality of life in menopausal women.

Objectives:

Hence the aim of this review was to evaluate the effects of self-directed learning (SDL) on MENQOl.

Conclusions:

Implementation of self-directed learning provides a useful strategy that should be included in health intervention and national surveillance programs in order to improve health and therapeutic compliance in postmenopausal women.

Results:

There were significant statistical differences between two groups regarding the age of subjects; age of menopause; economic, educational and employment status; number of dead and living children; BMI and vasomotor, physical, sexual and psycho-social postmenopausal symptoms. The implementation of Self-directed Learning (SDL) model leads to a significant statistical difference in scores of vasomotor symptoms (16.32 ± 5.92 to 13.26 ± 5.31), psychosocial symptoms (34.8 ± 11 to 27.18 ± 10.83), physical symptoms (75.02 ± 18.07 to 61.42 ± 15.49), sexual symptoms (15.36 ± 6.10 to 12.00 ± 4.97) and the overall score for quality of life (141.5 ± 41.09 to 113.86 ± 36.6) (P < 0.001). No significant changes were found in the QOL scores of the control group.

Patients and Methods:

The present single blind field study was conducted in Saadatmandi Health Center of Robat Karim (Iran, Southwest of Tehran Province) from August to December 2010. One handred and ten menopausal women were selected using convenience sampling method and then divided into two experimental (Self-directed Learning) and control groups of 55 each. Four manuals were developed to guide the women in the experimental group containing practical ways to treat menopausal symptoms. They were distributed among the participants for four weeks on a specific day. Menopausal Specific Quality of Life Questionnaire (MENQOL) was used to determine and compare quality of life scores of these women (before and three months after intervention sessions). The control group did not receive any intervention. Statistical analysis was performed by SPSS/16 software using Kolmogorov-Sminov, ANOVA, independent paired t test and Chi-square test.

Background:

One of the main criteria to verify the effectiveness of a health training program is to measure quality of life in menopausal women.

Objectives:

Hence the aim of this review was to evaluate the effects of self-directed learning (SDL) on MENQOl.

Self-Medication;Quality of Life;Menopausal Self-Medication;Quality of Life;Menopausal http://www.ircmj.com/index.php?page=article&article_id=13259 Mansoureh Yazdkhasti Mansoureh Yazdkhasti Department of Midwifery, Faculty of Midwifery and Instructor, Alborz University of Medical Sciences, Karaj, IR Iran; Department of Reproductive Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Midwifery, Faculty of Midwifery and Instructor, Alborz University of Medical Sciences, Karaj, IR Iran. Tel/Fax: +98-2632400339 Department of Midwifery, Faculty of Midwifery and Instructor, Alborz University of Medical Sciences, Karaj, IR Iran; Department of Reproductive Health, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Midwifery, Faculty of Midwifery and Instructor, Alborz University of Medical Sciences, Karaj, IR Iran. Tel/Fax: +98-2632400339 Maryam Keshavarz Maryam Keshavarz Department of Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran Department of Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran Zohreh Mahmoodi Zohreh Mahmoodi Social Determinant of Health Research Center, Alborz University of Medical Sciences, Karaj, IR Iran Social Determinant of Health Research Center, Alborz University of Medical Sciences, Karaj, IR Iran Agha Fatemeh Hosseini Agha Fatemeh Hosseini Department of Biostatistics, School of Management and Medical Information, Tehran University of Medical Sciences, Tehran, IR Iran Department of Biostatistics, School of Management and Medical Information, Tehran University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.13067 Indications and Overuse of Computed Tomography in Minor Head Trauma Indications and Overuse of Computed Tomography in Minor Head Trauma research-article research-article Objectives:

To identify a comprehensive list of indications for application of CT in patients with minor head trauma (MHT) and to determine appropriateness of its use on the basis of this list.

Conclusions:

On average, about 37% of the patients with MHT referring to the emergency departments had no indication of CT and approximately 86.5% of CT results were normal. Improving this situation can result in a significant saving in health care costs.

Results:

Of 400 patients who underwent CT after MHT, 187 (46.8%) patients had Glasgow coma scale (GCS) score of 13 or 14 at two hours post-trauma and 37 (19.8%) of these patients did not have any indication of imaging. In addition, 213 (53.2%) patients had GCS score of 15 out of which 110 (51.6%) patients did not have any indication of imaging. Patients with a GCS score of 15 had a noticeably lower proportion of abnormal CT results in comparison to patients with a GCS score of 13 or 14, (odds ratio, 19.07; 95% confidence interval, 6.74-54.00; and P < 0.001). There was a statistically significant association between abnormal CT results and the presence of indications including vomiting, dangerous mechanism of injury, visible signs of trauma above the clavicles, signs of skull base fracture, and suspected skull fracture (P < 0.001).

Background:

Computed Tomography (CT) is a useful diagnostic technology, particularly in accident and emergency departments.

Materials and Methods:

A cross-sectional study was conducted in three Imaging centers in Tehran. A panel of experts developed a list of CT indications for MHT by reviewing documents. A pre-structured checklist was designed and incorporated into a structured form. Four hundred consecutive patients referring to three imaging centers for performing CT due to MHT completed the questionnaire.

Objectives:

To identify a comprehensive list of indications for application of CT in patients with minor head trauma (MHT) and to determine appropriateness of its use on the basis of this list.

Conclusions:

On average, about 37% of the patients with MHT referring to the emergency departments had no indication of CT and approximately 86.5% of CT results were normal. Improving this situation can result in a significant saving in health care costs.

Results:

Of 400 patients who underwent CT after MHT, 187 (46.8%) patients had Glasgow coma scale (GCS) score of 13 or 14 at two hours post-trauma and 37 (19.8%) of these patients did not have any indication of imaging. In addition, 213 (53.2%) patients had GCS score of 15 out of which 110 (51.6%) patients did not have any indication of imaging. Patients with a GCS score of 15 had a noticeably lower proportion of abnormal CT results in comparison to patients with a GCS score of 13 or 14, (odds ratio, 19.07; 95% confidence interval, 6.74-54.00; and P < 0.001). There was a statistically significant association between abnormal CT results and the presence of indications including vomiting, dangerous mechanism of injury, visible signs of trauma above the clavicles, signs of skull base fracture, and suspected skull fracture (P < 0.001).

Background:

Computed Tomography (CT) is a useful diagnostic technology, particularly in accident and emergency departments.

Materials and Methods:

A cross-sectional study was conducted in three Imaging centers in Tehran. A panel of experts developed a list of CT indications for MHT by reviewing documents. A pre-structured checklist was designed and incorporated into a structured form. Four hundred consecutive patients referring to three imaging centers for performing CT due to MHT completed the questionnaire.

Tomography, X-Ray Computed;Craniocerebral Trauma;Indication;Abnormal Tomography, X-Ray Computed;Craniocerebral Trauma;Indication;Abnormal http://www.ircmj.com/index.php?page=article&article_id=13067 Sanaz Zargar Balaye Jame Sanaz Zargar Balaye Jame Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Reza Majdzadeh Reza Majdzadeh Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Ali Akbari Sari Ali Akbari Sari Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Health Management and Economics, and Knowledge Utilization Research Center, School of Public Health, Tehran University of Medical Sciences, Poorsina St, Tehran, IR Iran. Tel: +98-2188989129, Fax: +98-2188989129 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Health Management and Economics, and Knowledge Utilization Research Center, School of Public Health, Tehran University of Medical Sciences, Poorsina St, Tehran, IR Iran. Tel: +98-2188989129, Fax: +98-2188989129 Arash Rashidian Arash Rashidian Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran; Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, IR Iran Mohammad Arab Mohammad Arab Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Hojjat Rahmani Hojjat Rahmani Department of Health Care Management, School of Applied Medical Sciences, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Care Management, School of Applied Medical Sciences, Tehran University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.9661 Incidental Intrathecal Injection of Meglumine Diatrizoate Incidental Intrathecal Injection of Meglumine Diatrizoate case-report case-report Introduction:

Myelograghy is a process of instilling contrast medium to the subarachnoid space for evaluating the spinal column by radiography. There are various contrast solutions for different radiographic studies but not all of them are suitable for spinal column evaluation.

Conclusions:

Our subject recovered completely without any sequelae after receiving appropriate treatment in a multidisciplinary intensive care unit.

Case Presentation:

Our patient was a 60-year-old man who developed severe pain, tonic clonic convulsions and cardiopulmonary arrest after intrathecal injection of 14 mL of meglumine diatrizoate during an elective myelography procedure. Many of these cases would die or suffer from permanent sequelae if appropriate treatment is not received.

Introduction:

Myelograghy is a process of instilling contrast medium to the subarachnoid space for evaluating the spinal column by radiography. There are various contrast solutions for different radiographic studies but not all of them are suitable for spinal column evaluation.

Conclusions:

Our subject recovered completely without any sequelae after receiving appropriate treatment in a multidisciplinary intensive care unit.

Case Presentation:

Our patient was a 60-year-old man who developed severe pain, tonic clonic convulsions and cardiopulmonary arrest after intrathecal injection of 14 mL of meglumine diatrizoate during an elective myelography procedure. Many of these cases would die or suffer from permanent sequelae if appropriate treatment is not received.

Contrast Media;Edema, Brain;Intracranial Pressure Contrast Media;Edema, Brain;Intracranial Pressure http://www.ircmj.com/index.php?page=article&article_id=9661 Abbas Khosravi Abbas Khosravi Anesthesia and Intensive Care Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; ICU department, Iranian Hospital – Dubai, P.O.Box: 2330 , Dubai , UAE. Tel: +971-502242379, Fax: +971-43440322. Tel/Fax: +971-43440322 Anesthesia and Intensive Care Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; ICU department, Iranian Hospital – Dubai, P.O.Box: 2330 , Dubai , UAE. Tel: +971-502242379, Fax: +971-43440322. Tel/Fax: +971-43440322 Mansour Masjedi Mansour Masjedi Intensive Care Department, Iranian Hospital-Dubai, Dubai, UAE Intensive Care Department, Iranian Hospital-Dubai, Dubai, UAE Golnar Sabetian Golnar Sabetian Anesthesia and Intensive Care Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Anesthesia and Intensive Care Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Mohammad Reza Rahmanian Mohammad Reza Rahmanian Anesthesia and Intensive Care Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Anesthesia and Intensive Care Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.5812/ircmj.4899 Changes in Risk Factors and Exercise Capacity After Cardiac Rehabilitation and Its Effect on Hospital Readmission Changes in Risk Factors and Exercise Capacity After Cardiac Rehabilitation and Its Effect on Hospital Readmission research-article research-article Background:

Despite the positive outcomes reported with cardiac rehabilitation (CR), its impacts have been reported to be different from a region or country to another, which may be due to the different contents of rehabilitation programs.

Objectives:

To investigate the effect of CR on cardiovascular risk factors.

Patients and Methods:

This is a retrospective cohort study on the data from Imam Ali Cardiac Rehabilitation Center in Kermanshah province, Iran from 2001 to 2008. We used paired t-test to evaluate the effect of CR on cardiovascular risk factors. Logistic regression or t-test (unequal variance) were used to assess the factors influencing re-admission (due to cardiac problems). The relationship between different variables and death was studied using univariate cox proportional hazard. P values < 0.05 were considered significant for all analyses.

Results:

Out of 504 patients who completed rehabilitation, a total of 499 were analyzed. These 499 patients consisted of 383 men and 116 women. All anthropometric measurements, blood lipids (except HDL cholesterol), systolic and diastolic blood pressure, depression, anxiety and exercise capacity improved after rehabilitation (P < 0.05 for all cases). The improvement was observed in both sexes. A total of 39 patients were re-admitted to hospital after rehabilitation. Being female (OR = 2.40; 95%CI: 1.22-4.68) and history of diabetes (OR = 2.04; 95%CI: 1.04-4.02) increased the risk of re-admission significantly. Patients who were readmitted had higher anthropometric measurements at the beginning and the end of the program. Moreover, the initial exercise capacity of readmitted patients was lower than those who were not readmitted. After a maximal follow-up period of 6.3 years (median = 2.99 years), only eight patients expired (survival rate: 97.5%; 95%CI: 94.7-98.8). None of the variables in our study was significantly related to the survival rate.

Conclusions:

The comprehensive CR program in Imam Ali Center efficiently reduces cardiovascular risk factors and improves exercise capacity.

Background:

Despite the positive outcomes reported with cardiac rehabilitation (CR), its impacts have been reported to be different from a region or country to another, which may be due to the different contents of rehabilitation programs.

Objectives:

To investigate the effect of CR on cardiovascular risk factors.

Patients and Methods:

This is a retrospective cohort study on the data from Imam Ali Cardiac Rehabilitation Center in Kermanshah province, Iran from 2001 to 2008. We used paired t-test to evaluate the effect of CR on cardiovascular risk factors. Logistic regression or t-test (unequal variance) were used to assess the factors influencing re-admission (due to cardiac problems). The relationship between different variables and death was studied using univariate cox proportional hazard. P values < 0.05 were considered significant for all analyses.

Results:

Out of 504 patients who completed rehabilitation, a total of 499 were analyzed. These 499 patients consisted of 383 men and 116 women. All anthropometric measurements, blood lipids (except HDL cholesterol), systolic and diastolic blood pressure, depression, anxiety and exercise capacity improved after rehabilitation (P < 0.05 for all cases). The improvement was observed in both sexes. A total of 39 patients were re-admitted to hospital after rehabilitation. Being female (OR = 2.40; 95%CI: 1.22-4.68) and history of diabetes (OR = 2.04; 95%CI: 1.04-4.02) increased the risk of re-admission significantly. Patients who were readmitted had higher anthropometric measurements at the beginning and the end of the program. Moreover, the initial exercise capacity of readmitted patients was lower than those who were not readmitted. After a maximal follow-up period of 6.3 years (median = 2.99 years), only eight patients expired (survival rate: 97.5%; 95%CI: 94.7-98.8). None of the variables in our study was significantly related to the survival rate.

Conclusions:

The comprehensive CR program in Imam Ali Center efficiently reduces cardiovascular risk factors and improves exercise capacity.

Rehabilitation;Exercise Tolerance;Patient Readmission;Risk Factors Rehabilitation;Exercise Tolerance;Patient Readmission;Risk Factors http://www.ircmj.com/index.php?page=article&article_id=4899 Farid Najafi Farid Najafi Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, IR Iran; Vice Chancellery of Research and Technology, Kermanshah University of Medical Sciences, Building No 2, Shahid Beheshti Blvd, Kermanshah, IR Iran, Tel: +98-9183853465, Fax: +98-8318392834 Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, IR Iran; Vice Chancellery of Research and Technology, Kermanshah University of Medical Sciences, Building No 2, Shahid Beheshti Blvd, Kermanshah, IR Iran, Tel: +98-9183853465, Fax: +98-8318392834 Mehdi Nalini Mehdi Nalini Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, IR Iran; Vice Chancellery of Research and Technology, Kermanshah University of Medical Sciences, Building No 2, Shahid Beheshti Blvd, Kermanshah, IR Iran, Tel:+98-9183853465, Fax: +98-8318392834 Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, IR Iran; Vice Chancellery of Research and Technology, Kermanshah University of Medical Sciences, Building No 2, Shahid Beheshti Blvd, Kermanshah, IR Iran, Tel:+98-9183853465, Fax: +98-8318392834 Mohammad Reza Nikbakht Mohammad Reza Nikbakht School of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, IR Iran School of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
en 10.5812/ircmj.5072 Delayed Polyneuropathy in Farm Sprayers Due to Chronic Low Dose Pesticide Exposure Delayed Polyneuropathy in Farm Sprayers Due to Chronic Low Dose Pesticide Exposure research-article research-article Background:

The use of organophosphates (OPs) in developing countries is rising in large quantities and non-secure methods. This problem not only causes acute poisoning but also may lead to chronic diseases such as polyneuropathy. In Iran, 60% of pesticides are organophosphate compounds that may lead to delayed polyneuropathy.

Objectives:

The purpose of the current study was to evaluate delayed polyneuropathy in farm sprayers due to chronic low dose pesticide exposure.

Patients and Methods:

In our cross-sectional study, non-randomized sampling method was performed and 100 farm sprayers (cases) and 100 hospital personnel (controls) after precise systemic and neurological examination were recruited to this study from June 2011 to august 2011. The nerve conduction studies were performed and these indices were recorded: Compound Muscle Action Potential (CMAP), amplitude and Distal Latency (DL) and Nerve Conduction Velocity (NCV) of common peroneal nerve, Peak Latency (PL) and amplitude of Sensory Nerve Action Potential (SNAP) and Nerve Conduction Velocity (NCV) of sural and radial sensory nerves.

Results:

Among 100 cases, 55 farm sprayers complained of non-neurological problems including: ophthalmologic, dermatologic and pulmonary complications. The ophthalmologic complaints (44%) were the most. The mean peroneal CMAP amplitude and NCV, sural PL, radial SNAP amplitude, PL and NCV in the case group were significantly different compared to control group. Mean exposure time to OPs in farm sprayers without neurological problem (40%) was 11.81 ± 5.84 years but in farm sprayers with neurological problems (60%) was 15.70 ± 9.08 years, which represents the effect of OPs exposure duration on neurologic problems.

Conclusions:

Chronic low dose pesticide exposure could lead to delayed peripheral neuropathy as well as systemic (skin, eyes and lungs) complications. In farm sprayers electrodiagnostic indices were significantly abnormal as compared to control group. The normal indices did not rule out neurologic involvement and it seems that measurement of these indices at the beginning of the farm sprayers employment and intermittently during their work is helpful for detecting delayed polyneuropathy.

Background:

The use of organophosphates (OPs) in developing countries is rising in large quantities and non-secure methods. This problem not only causes acute poisoning but also may lead to chronic diseases such as polyneuropathy. In Iran, 60% of pesticides are organophosphate compounds that may lead to delayed polyneuropathy.

Objectives:

The purpose of the current study was to evaluate delayed polyneuropathy in farm sprayers due to chronic low dose pesticide exposure.

Patients and Methods:

In our cross-sectional study, non-randomized sampling method was performed and 100 farm sprayers (cases) and 100 hospital personnel (controls) after precise systemic and neurological examination were recruited to this study from June 2011 to august 2011. The nerve conduction studies were performed and these indices were recorded: Compound Muscle Action Potential (CMAP), amplitude and Distal Latency (DL) and Nerve Conduction Velocity (NCV) of common peroneal nerve, Peak Latency (PL) and amplitude of Sensory Nerve Action Potential (SNAP) and Nerve Conduction Velocity (NCV) of sural and radial sensory nerves.

Results:

Among 100 cases, 55 farm sprayers complained of non-neurological problems including: ophthalmologic, dermatologic and pulmonary complications. The ophthalmologic complaints (44%) were the most. The mean peroneal CMAP amplitude and NCV, sural PL, radial SNAP amplitude, PL and NCV in the case group were significantly different compared to control group. Mean exposure time to OPs in farm sprayers without neurological problem (40%) was 11.81 ± 5.84 years but in farm sprayers with neurological problems (60%) was 15.70 ± 9.08 years, which represents the effect of OPs exposure duration on neurologic problems.

Conclusions:

Chronic low dose pesticide exposure could lead to delayed peripheral neuropathy as well as systemic (skin, eyes and lungs) complications. In farm sprayers electrodiagnostic indices were significantly abnormal as compared to control group. The normal indices did not rule out neurologic involvement and it seems that measurement of these indices at the beginning of the farm sprayers employment and intermittently during their work is helpful for detecting delayed polyneuropathy.

Pesticides;Neurotoxicity Syndromes;Polyneuropathies;Electrodiagnosis;Organophosphates Pesticides;Neurotoxicity Syndromes;Polyneuropathies;Electrodiagnosis;Organophosphates http://www.ircmj.com/index.php?page=article&article_id=5072 Reza Boostani Reza Boostani Neurology Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran Neurology Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran Ali Mellat Ali Mellat Neurology Department, Shahid Sadoughi Hospital, Yazd University of Medical Sciences, Yazd, IR Iran; Shahid Sadoughi Hospital, Yazd University of Medical Sciences, Yazd, IR Iran. Tel/Fax: +98-3518224001 Neurology Department, Shahid Sadoughi Hospital, Yazd University of Medical Sciences, Yazd, IR Iran; Shahid Sadoughi Hospital, Yazd University of Medical Sciences, Yazd, IR Iran. Tel/Fax: +98-3518224001 Reza Afshari Reza Afshari Medical Toxicology Research Centre, Mashhad University of Medical Sciences, Mashhad, IR Iran Medical Toxicology Research Centre, Mashhad University of Medical Sciences, Mashhad, IR Iran Siavash Derakhshan Siavash Derakhshan Neurology Department, North Khorasan University of Medical Sciences, Bojnourd, IR Iran Neurology Department, North Khorasan University of Medical Sciences, Bojnourd, IR Iran Morteza Saeedi Morteza Saeedi Neurology Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran Neurology Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran Ehsan Rafeemanesh Ehsan Rafeemanesh Occupational and Environmental Health Department, Mashhad University of Medical Sciences, Mashhad, IR Iran Occupational and Environmental Health Department, Mashhad University of Medical Sciences, Mashhad, IR Iran Maryam Mellat Maryam Mellat Physical Medicine and Rehabilitation Department, Isfahan University of Medical Sciences, Isfahan, IR Iran Physical Medicine and Rehabilitation Department, Isfahan University of Medical Sciences, Isfahan, IR Iran
en 10.5812/ircmj.6897 Leech Therapy in Nearly Total Amputation of Fingers Without Vascular Repair: A Case Report Leech Therapy in Nearly Total Amputation of Fingers Without Vascular Repair: A Case Report case-report case-report Introduction:

In the absence of microvascular replantation or in crash injury cases in which obtaining an acceptable function is not possible, amputation of the injured finger seems to be the best treatment modality. Some studies recommended leech therapy for this kind of injury after vascular repair to decrease venous congestion.

Case Presentation:

In this case report, the authors presented a case of leech therapy after near total amputation of the fingers. A 25-year-old patient was admitted following a sawing injury with crashed bundles of the third, fourth and fifth fingers. Microvascular surgery was not performed because of crush injury.

Discussion:

After a simple repair and pin fixation, the patient was treated using leech therapy. The result was satisfactory. The third and fourth fingers were salvaged. It seems that in cases where a small part of the skin is still attached to the amputated part, even with complete crash of both bundles, leech therapy can help salvage the amputated fingers.

Introduction:

In the absence of microvascular replantation or in crash injury cases in which obtaining an acceptable function is not possible, amputation of the injured finger seems to be the best treatment modality. Some studies recommended leech therapy for this kind of injury after vascular repair to decrease venous congestion.

Case Presentation:

In this case report, the authors presented a case of leech therapy after near total amputation of the fingers. A 25-year-old patient was admitted following a sawing injury with crashed bundles of the third, fourth and fifth fingers. Microvascular surgery was not performed because of crush injury.

Discussion:

After a simple repair and pin fixation, the patient was treated using leech therapy. The result was satisfactory. The third and fourth fingers were salvaged. It seems that in cases where a small part of the skin is still attached to the amputated part, even with complete crash of both bundles, leech therapy can help salvage the amputated fingers.

Leeches;Amputation;Vascular System Injuries;Hyperemia Leeches;Amputation;Vascular System Injuries;Hyperemia http://www.ircmj.com/index.php?page=article&article_id=6897 Mohammad TarazJamshidi Mohammad TarazJamshidi Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Farshid Bagheri Farshid Bagheri Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Masud Mirkazemi Masud Mirkazemi Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Sara Amelfarzad Sara Amelfarzad Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IR Iran Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IR Iran Hami Ashraf Hami Ashraf Department of Research and Education, Razavi Hospital, Mashhad, IR Iran Department of Research and Education, Razavi Hospital, Mashhad, IR Iran Mehran Azami Mehran Azami Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Mohammad Taghi Peivandi Mohammad Taghi Peivandi Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran; Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel/Fax: +98-5118523200 Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran; Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel/Fax: +98-5118523200
en 10.5812/ircmj.5323 Quality of Life in Iranian Chemical Warfare Veteran's Quality of Life in Iranian Chemical Warfare Veteran's research-article research-article Background:

Mustard gas has different effects on different body systems such as respiratory tract, blood, gastrointestinal, skin, eye, endocrine and peripheral nervous system.

Objectives:

The purpose of this study was to determine the quality of life in chemical warfare veterans due to sulfur mustard exposure.

Patients and Methods:

In a cross-sectional and analytic study, 242 patients who had a chemical injury during the Iran-Iraq war (1980-1983) and their lung damage was proven were investigated in our study. The quality of life was measured in these patients using an extensively validated Iranian version of SF-36.

Results:

The mean age of veterans was 44.12 ± 4.9 ranging from 22 to 62 years. Our results showed that chemical warfare had a decreased quality of life in all subscales of the SF-36. The lowest scores in SF-36 subscales were related to role physical and general health. The data also showed a significant relationship between the number of organs involved and the quality of life in these patients (P < 0.001, r = − 0.33). So that the patients who had more than three organs involved had lower quality of life. 95.4% of our participants experienced another complication with respiratory complication and the ophthalmologic complications were the most frequent accompanying condition.

Conclusions:

The results imply that chemical warfare survivors suffering from late complications have a low health related quality of life.

Background:

Mustard gas has different effects on different body systems such as respiratory tract, blood, gastrointestinal, skin, eye, endocrine and peripheral nervous system.

Objectives:

The purpose of this study was to determine the quality of life in chemical warfare veterans due to sulfur mustard exposure.

Patients and Methods:

In a cross-sectional and analytic study, 242 patients who had a chemical injury during the Iran-Iraq war (1980-1983) and their lung damage was proven were investigated in our study. The quality of life was measured in these patients using an extensively validated Iranian version of SF-36.

Results:

The mean age of veterans was 44.12 ± 4.9 ranging from 22 to 62 years. Our results showed that chemical warfare had a decreased quality of life in all subscales of the SF-36. The lowest scores in SF-36 subscales were related to role physical and general health. The data also showed a significant relationship between the number of organs involved and the quality of life in these patients (P < 0.001, r = − 0.33). So that the patients who had more than three organs involved had lower quality of life. 95.4% of our participants experienced another complication with respiratory complication and the ophthalmologic complications were the most frequent accompanying condition.

Conclusions:

The results imply that chemical warfare survivors suffering from late complications have a low health related quality of life.

Quality of Life;Chemical Warfare;Veteran;Chronic Disease Quality of Life;Chemical Warfare;Veteran;Chronic Disease http://www.ircmj.com/index.php?page=article&article_id=5323 Abbas Ebadi Abbas Ebadi Behavioral Sciences Research Center (BSRC), Nursing Faculty of Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Behavioral Sciences Research Center (BSRC), Nursing Faculty of Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-9122149019 Behavioral Sciences Research Center (BSRC), Nursing Faculty of Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Behavioral Sciences Research Center (BSRC), Nursing Faculty of Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-9122149019 Tayeb Moradian Tayeb Moradian Department of Medical Surgical, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Department of Medical Surgical, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Mohsen Mollahadi Mohsen Mollahadi Department of Pediatric, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Department of Pediatric, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Yaser Saeed Yaser Saeed Department of Critical Care, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Department of Critical Care, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Ali Akbar Refahi Ali Akbar Refahi Behavioral Sciences Research Center (BSRC), Nursing Faculty of Baqiyatallah University of Medical Sciences, Tehran, IR Iran Behavioral Sciences Research Center (BSRC), Nursing Faculty of Baqiyatallah University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.6656 Metabolic Syndrome, Insulin Resistance and Fatty Liver in Obese Iranian Children Metabolic Syndrome, Insulin Resistance and Fatty Liver in Obese Iranian Children research-article research-article Conclusions:

Prevalence of fatty liver is high in our obese children. It was associated with criteria of metabolic syndrome and insulin resistance, so visceral fat may participate in the pathogenesis of the metabolic syndrome or merely serve as a marker of increased risk for the metabolic complications of obesity.

Patients and Methods:

102 obese Iranian children, referred to pediatric clinics from March 2011 to March 2012, were enrolled in this cross-sectional study. All the patients were visited by a pediatric endocrinologist, a pediatric gastroenterologist and an expert radiologist in the evaluation of fatty liver grading.

Results:

The grade of fatty liver was higher in older children (P = 0.001). It was also more in taller and heavier children (P = 0.000). The more the BMI was, the more the fatty liver grade was (P = 0.002). Severity of fatty liver according to liver sonography in patient had a positive relationship with waist circumference, hip circumference, serum TG, serum FBS, serum fasting insulin, serum ALT, systolic blood pressure and HOMA index and had a negative correlation with the level of alkaline phosphatase. Severity of fatty liver also had a close relationship with the presence of acanthosis nigricans and HOMA index.

Background:

Obesity is a global epidemic and its morbidities such as metabolic syndrome, insulin resistance, and fatty liver leads to a spectrum of psycho-social and medical consequences.

Objectives:

The objective of this study was to investigate the prevalence of fatty liver in obese Iranian children and its' association with metabolic syndrome and insulin resistance.

Conclusions:

Prevalence of fatty liver is high in our obese children. It was associated with criteria of metabolic syndrome and insulin resistance, so visceral fat may participate in the pathogenesis of the metabolic syndrome or merely serve as a marker of increased risk for the metabolic complications of obesity.

Patients and Methods:

102 obese Iranian children, referred to pediatric clinics from March 2011 to March 2012, were enrolled in this cross-sectional study. All the patients were visited by a pediatric endocrinologist, a pediatric gastroenterologist and an expert radiologist in the evaluation of fatty liver grading.

Results:

The grade of fatty liver was higher in older children (P = 0.001). It was also more in taller and heavier children (P = 0.000). The more the BMI was, the more the fatty liver grade was (P = 0.002). Severity of fatty liver according to liver sonography in patient had a positive relationship with waist circumference, hip circumference, serum TG, serum FBS, serum fasting insulin, serum ALT, systolic blood pressure and HOMA index and had a negative correlation with the level of alkaline phosphatase. Severity of fatty liver also had a close relationship with the presence of acanthosis nigricans and HOMA index.

Background:

Obesity is a global epidemic and its morbidities such as metabolic syndrome, insulin resistance, and fatty liver leads to a spectrum of psycho-social and medical consequences.

Objectives:

The objective of this study was to investigate the prevalence of fatty liver in obese Iranian children and its' association with metabolic syndrome and insulin resistance.

Insulin Resistance;Fatty liver;Obesity;Children;Iran Insulin Resistance;Fatty liver;Obesity;Children;Iran http://www.ircmj.com/index.php?page=article&article_id=6656 Forough Saki Forough Saki Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: +98-7116473096 Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: +98-7116473096 Zohreh Karamizadeh Zohreh Karamizadeh Division of Endocrinology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran Division of Endocrinology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.5812/ircmj.11502 Transdermal Fentanyl Patches Versus Patient-Controlled Intravenous Morphine Analgesia for Postoperative Pain Management Transdermal Fentanyl Patches Versus Patient-Controlled Intravenous Morphine Analgesia for Postoperative Pain Management research-article research-article Conclusions:

Although both pain killing therapeutic regimens are safe and effective for postoperative pain management, regarding the easy usage of the patches, lower risk of abuse and cost-effectiveness in the Iranian market, it is recommended for use in Iranian hospitals and trauma centers and in countries with similar socioeconomic situations.

Background:

Acute and severe pain is common in patients postoperatively and should be correctly managed. In the past years studies on preparing better postoperative pain control have resulted in development of postoperative pain management guidelines. Perhaps, one of the major improvements in managing postoperative pain is the development of the patient-controlled analgesia systems (PCA), especially through intra venous (IV), extradural and transdermal routes, which has resulted in marked improvements in acute postoperative pain management. Physicians administrate potent opioids for moderate to severe post-surgical pains. Morphine is the most commonly IV-PCA administrated analgesic. The fentanyl iontophoretic transdermal system (fentanyl ITS) is also another efficient option for pain management.

Results:

No significant difference was observed in mean pain intensity score at the first patient assessment. Mean pain intensity scores were also similar in both groups at the last measured time point (P > 0.05). Differential pain intensity scores, showing the impacts of analgesic system on the pain experience of the patients was also similar between fentanyl patches (6.48 ± 2.20) and morphine PCIA (6.40 ± 1.80). (P > 0.05) Mean patient satisfactory score (scale: 0–100) was also similar in both groups (P > 0.05). The percentage of patients, whose differential pain intensity scores at 24 hours reached our pain management goal was similar between fentanyl and morphine groups (P > 0.05). The percentage of patients with at least one adverse event was significantly higher in fentanyl group (P < 0.05). The most frequent adverse events were nausea, vomiting and itching. In none of the groups, no patient experienced serious adverse events related to the studied medications.

Patients and Methods:

We enrolled 281 patients (224 males, 57 females) in this blind randomized controlled clinical trial, who had undergone an orthopedic surgery, with the mean age of 33.91 ± 14.45 years. Patients were randomly divided into two groups; in group A patients received IV-morphine PCA pump and in group B fentanyl transdermal patches were attached on patients’ arms. The severity of the pain was registered according to Visual Analogue Scale in specially designed forms by pain-trained nurses in two steps; first after the surgery and next before the beginning of analgesic effects. After 24 hours, the pain score was assessed again.

Objectives:

The aim of this study was to compare the analgesic effects of these two routine postoperative pain control systems.

Conclusions:

Although both pain killing therapeutic regimens are safe and effective for postoperative pain management, regarding the easy usage of the patches, lower risk of abuse and cost-effectiveness in the Iranian market, it is recommended for use in Iranian hospitals and trauma centers and in countries with similar socioeconomic situations.

Background:

Acute and severe pain is common in patients postoperatively and should be correctly managed. In the past years studies on preparing better postoperative pain control have resulted in development of postoperative pain management guidelines. Perhaps, one of the major improvements in managing postoperative pain is the development of the patient-controlled analgesia systems (PCA), especially through intra venous (IV), extradural and transdermal routes, which has resulted in marked improvements in acute postoperative pain management. Physicians administrate potent opioids for moderate to severe post-surgical pains. Morphine is the most commonly IV-PCA administrated analgesic. The fentanyl iontophoretic transdermal system (fentanyl ITS) is also another efficient option for pain management.

Results:

No significant difference was observed in mean pain intensity score at the first patient assessment. Mean pain intensity scores were also similar in both groups at the last measured time point (P > 0.05). Differential pain intensity scores, showing the impacts of analgesic system on the pain experience of the patients was also similar between fentanyl patches (6.48 ± 2.20) and morphine PCIA (6.40 ± 1.80). (P > 0.05) Mean patient satisfactory score (scale: 0–100) was also similar in both groups (P > 0.05). The percentage of patients, whose differential pain intensity scores at 24 hours reached our pain management goal was similar between fentanyl and morphine groups (P > 0.05). The percentage of patients with at least one adverse event was significantly higher in fentanyl group (P < 0.05). The most frequent adverse events were nausea, vomiting and itching. In none of the groups, no patient experienced serious adverse events related to the studied medications.

Patients and Methods:

We enrolled 281 patients (224 males, 57 females) in this blind randomized controlled clinical trial, who had undergone an orthopedic surgery, with the mean age of 33.91 ± 14.45 years. Patients were randomly divided into two groups; in group A patients received IV-morphine PCA pump and in group B fentanyl transdermal patches were attached on patients’ arms. The severity of the pain was registered according to Visual Analogue Scale in specially designed forms by pain-trained nurses in two steps; first after the surgery and next before the beginning of analgesic effects. After 24 hours, the pain score was assessed again.

Objectives:

The aim of this study was to compare the analgesic effects of these two routine postoperative pain control systems.

Fentanyl;Morphine;Analgesia;Patients;Pain Management;Postoperative Period Fentanyl;Morphine;Analgesia;Patients;Pain Management;Postoperative Period http://www.ircmj.com/index.php?page=article&article_id=11502 Mohamad Hossein Ebrahimzadeh Mohamad Hossein Ebrahimzadeh Department of Orthopedic Surgery, Orthopedic and Trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Orthopedic Surgery, Orthopedic and Trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Seyed Kamal Mousavi Seyed Kamal Mousavi Department of Orthopedic Surgery, Orthopedic and Trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Orthopedic Surgery, Orthopedic and Trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Hami Ashraf Hami Ashraf Orthopedic and trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Orthopedic and trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Rahil Abubakri Rahil Abubakri Orthopedic and trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Orthopedic and trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran Ali Birjandinejad Ali Birjandinejad Department of Orthopedic Surgery, Orthopedic and Trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran; Department of Orthopedic Surgery, Orthopedic and Trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118424685 Department of Orthopedic Surgery, Orthopedic and Trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran; Department of Orthopedic Surgery, Orthopedic and Trauma Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118424685
en 10.5812/ircmj.18199 Tracheobronchial Foreign Body Aspiration Demonstrating Serial Bronchopulmonary Changes on Computed Tomography Tracheobronchial Foreign Body Aspiration Demonstrating Serial Bronchopulmonary Changes on Computed Tomography case-report case-report Introduction:

Tracheobronchial foreign body may often be treated as asthma, chronic bronchitis or etc. especially in patients with no memories of aspiration episodes.

Case Presentation:

A 74-year-old woman, suffering from persistent cough, was temporarily misdiagnosed with allergic bronchopulmonary aspergillosis and treated for six months. During this period, computed tomography (CT) findings changed from thickened bronchial walls and a “tree-in-bud” pattern to clubbing bronchiectasis and atelectasis, and no significant bacteria was detected. Finally, a vegetable core was subsequently extracted via flexible bronchofiberscopy. Although the patient's symptoms improved dramatically, the bronchopulmonary lesion remained practically.

Conclusions:

We assume that chronologic CT findings of the bronchopulmonary damage by aspiration of a vegetable core, without significant detection of bacteria during the course, will be quite valuable for clinicians.

Introduction:

Tracheobronchial foreign body may often be treated as asthma, chronic bronchitis or etc. especially in patients with no memories of aspiration episodes.

Case Presentation:

A 74-year-old woman, suffering from persistent cough, was temporarily misdiagnosed with allergic bronchopulmonary aspergillosis and treated for six months. During this period, computed tomography (CT) findings changed from thickened bronchial walls and a “tree-in-bud” pattern to clubbing bronchiectasis and atelectasis, and no significant bacteria was detected. Finally, a vegetable core was subsequently extracted via flexible bronchofiberscopy. Although the patient's symptoms improved dramatically, the bronchopulmonary lesion remained practically.

Conclusions:

We assume that chronologic CT findings of the bronchopulmonary damage by aspiration of a vegetable core, without significant detection of bacteria during the course, will be quite valuable for clinicians.

Granuloma, Foreign-Body;Vegetables;Bronchiectasis Granuloma, Foreign-Body;Vegetables;Bronchiectasis http://www.ircmj.com/index.php?page=article&article_id=18199 Hidehiro Watanabe Hidehiro Watanabe Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan; Division of Respiratory Medicine, Tokai University Hachioji Hospital, Tokyo, Japan; Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuou, Ami, Inashiki, Ibaraki 300-0395 Japan. Tel: +81-298871161 Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan; Division of Respiratory Medicine, Tokai University Hachioji Hospital, Tokyo, Japan; Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuou, Ami, Inashiki, Ibaraki 300-0395 Japan. Tel: +81-298871161 Tomonori Uruma Tomonori Uruma Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan; Division of Respiratory Medicine, Tokai University Hachioji Hospital, Tokyo, Japan Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan; Division of Respiratory Medicine, Tokai University Hachioji Hospital, Tokyo, Japan Gen Tazaki Gen Tazaki Division of Respiratory Medicine, Tokai University Hachioji Hospital, Tokyo, Japan Division of Respiratory Medicine, Tokai University Hachioji Hospital, Tokyo, Japan
en 10.5812/ircmj.17784 Hydro-Methanolic Extract of Cornus Mas L. and Blood Glucose, Lipid Profile and Hematological Parameters of Male Rats Hydro-Methanolic Extract of <italic>Cornus Mas</italic> L. and Blood Glucose, Lipid Profile and Hematological Parameters of Male Rats research-article research-article Background:

Cornus mas L, an olive-shaped red-colored single-seeded fruit, is used in traditional medicine in different parts of Europe and Asia.

Objectives:

In the present study, 40 male Wistar rats were randomly divided into five groups, and the effects of 21 days of intraperitoneally (IP) administration of 50, 200 and 400 mg/kg body weight of C. mas hydro-methanolic extract on the rats hematological and biochemical parameters were investigated. The experimental study was carried out in Tabriz, Iran.

Materials and Methods:

The hematology and biochemical tests were performed by the Technicon H1 Hematology Analyzer and enzymatic methods, respectively.

Results:

The results indicated that all doses of the extract caused significant (P < 0.05) decreases in the hemoglobin distribution width (HDW) (2.3 ± 0.2 vs. 2.5 ± 0.2, P = 0.049) and platelet distribution width (PDW) (56.5 ± 1.8 vs. 63.9 ± 3.6, P = 0.001) of the treated groups vs. control group, whereas only high doses caused significant elevation in the mean corpuscular hemoglobin concentration (MCHC) (30.3 ± 0.8 vs. 28.6 ± 0.6, P = 0.047), mean platelet volume (MPV) (5.0 ± 0.6 vs. 4.1 ± 0.3, P = 0.002), total platelet mass (PCT) (0.33 ± 0.07 vs. 0.26 ± 0.01, P = 0.050), and significant decrease in the red cell distribution width (RDW) (13.8 ± 0.4 vs. 14.7 ± 1.3, P = 0.048) of the treated groups vs. control group.

Conclusions:

Decreasing effect of the extract on platelet activity might classify it as an alternative for antiplatelet therapy in cardiovascular diseases (CVD). The results of this study suggested that further investigations with higher doses of C. mas fruit extract are necessary to obtain significant protective and nonprotective changes in hematological and biochemical parameters.

Background:

Cornus mas L, an olive-shaped red-colored single-seeded fruit, is used in traditional medicine in different parts of Europe and Asia.

Objectives:

In the present study, 40 male Wistar rats were randomly divided into five groups, and the effects of 21 days of intraperitoneally (IP) administration of 50, 200 and 400 mg/kg body weight of C. mas hydro-methanolic extract on the rats hematological and biochemical parameters were investigated. The experimental study was carried out in Tabriz, Iran.

Materials and Methods:

The hematology and biochemical tests were performed by the Technicon H1 Hematology Analyzer and enzymatic methods, respectively.

Results:

The results indicated that all doses of the extract caused significant (P < 0.05) decreases in the hemoglobin distribution width (HDW) (2.3 ± 0.2 vs. 2.5 ± 0.2, P = 0.049) and platelet distribution width (PDW) (56.5 ± 1.8 vs. 63.9 ± 3.6, P = 0.001) of the treated groups vs. control group, whereas only high doses caused significant elevation in the mean corpuscular hemoglobin concentration (MCHC) (30.3 ± 0.8 vs. 28.6 ± 0.6, P = 0.047), mean platelet volume (MPV) (5.0 ± 0.6 vs. 4.1 ± 0.3, P = 0.002), total platelet mass (PCT) (0.33 ± 0.07 vs. 0.26 ± 0.01, P = 0.050), and significant decrease in the red cell distribution width (RDW) (13.8 ± 0.4 vs. 14.7 ± 1.3, P = 0.048) of the treated groups vs. control group.

Conclusions:

Decreasing effect of the extract on platelet activity might classify it as an alternative for antiplatelet therapy in cardiovascular diseases (CVD). The results of this study suggested that further investigations with higher doses of C. mas fruit extract are necessary to obtain significant protective and nonprotective changes in hematological and biochemical parameters.

Cornus;Biological Markers;Hematologic Tests;Blood Glucose Cornus;Biological Markers;Hematologic Tests;Blood Glucose http://www.ircmj.com/index.php?page=article&article_id=17784 Bita Abdollahi Bita Abdollahi Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Mehran Mesgari Abbasi Mehran Mesgari Abbasi Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IR Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel:+98-9141168681 Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IR Iran; Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel:+98-9141168681 Parvin Zakeri Milani Parvin Zakeri Milani Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IR Iran Student Research Committee, Tabriz University of Medical Sciences, Tabriz, IR Iran Ashraf Sadat Nourdadgar Ashraf Sadat Nourdadgar Medical Education Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Medical Education Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Seyyed Mehdi Banan Khojasteh Seyyed Mehdi Banan Khojasteh Department of Natural Sciences, Faculty of Natural Sciences, University of Tabriz, Tabriz, IR Iran Department of Natural Sciences, Faculty of Natural Sciences, University of Tabriz, Tabriz, IR Iran Vahid Nejati Vahid Nejati Faculty of Science, Urmia University, Urmia, IR Iran Faculty of Science, Urmia University, Urmia, IR Iran
en 10.5812/ircmj.17648 Detecting and Accommodating Outliers in Meta-Analysis for Evaluating Effect of Albendazole on Ascaris lumbricoides Infection Detecting and Accommodating Outliers in Meta-Analysis for Evaluating Effect of Albendazole on <italic>Ascaris lumbricoides Infection</italic> research-article research-article Conclusions:

We can detect and accommodate outliers in meta-analysis by using random effects variance shift model and likelihood ratio test.

Results:

According to meta-analysis results, the estimate for RR was 2.91, with a 95% confidence interval of 2.6 to 3.25. According to the method used in this study, three articles (articles number 4, 7, and 12) were outliers and, as such, they were detected in the graphs.

Patients and Methods:

The study used data from 14 clinical trials; each article was composed of two groups, a treatment group and a placebo group. These articles compared the effect of single dose intakes of 400 mg albendazole in treating two groups of patients with Ascaris lumbricoides infection. The articles were published in a number of internationally indexed journals between 1983 to 2013. For both groups in each article, the total number of participants, the number of those with Ascaris lumbricoides infection, and the number of those recovered following the intake of albendazole were identified and recorded. The relative risk (RR) and variance were computed for each article individually. Then, using meta-analysis, the RR was computed for all the articles together. In order to detect outliers the "random effects variance shift model" and "likelihood ratio test" (LRT) were used. Adopting the bootstrap method, the accuracy rates for sampling distribution of the tests, which were used for multiple testing, were obtained and the relevant graphs were depicted. For data analysis, STATA and R software were used.

Objectives:

The current study uses "random effects variance shift model" to evaluate and correct the outliers in performing a meta-analysis study of the effect of albendazole in treating patients with Ascaris lumbricoides infection.

Background:

Meta-analysis is a statistical technique in which the results of two or more independent studies, with similar objectives, are mathematically combined in order to improve the reliability of the results. The outliers, which may exist even in random models, can affect the validity and strength of meta-analysis results.

Conclusions:

We can detect and accommodate outliers in meta-analysis by using random effects variance shift model and likelihood ratio test.

Results:

According to meta-analysis results, the estimate for RR was 2.91, with a 95% confidence interval of 2.6 to 3.25. According to the method used in this study, three articles (articles number 4, 7, and 12) were outliers and, as such, they were detected in the graphs.

Patients and Methods:

The study used data from 14 clinical trials; each article was composed of two groups, a treatment group and a placebo group. These articles compared the effect of single dose intakes of 400 mg albendazole in treating two groups of patients with Ascaris lumbricoides infection. The articles were published in a number of internationally indexed journals between 1983 to 2013. For both groups in each article, the total number of participants, the number of those with Ascaris lumbricoides infection, and the number of those recovered following the intake of albendazole were identified and recorded. The relative risk (RR) and variance were computed for each article individually. Then, using meta-analysis, the RR was computed for all the articles together. In order to detect outliers the "random effects variance shift model" and "likelihood ratio test" (LRT) were used. Adopting the bootstrap method, the accuracy rates for sampling distribution of the tests, which were used for multiple testing, were obtained and the relevant graphs were depicted. For data analysis, STATA and R software were used.

Objectives:

The current study uses "random effects variance shift model" to evaluate and correct the outliers in performing a meta-analysis study of the effect of albendazole in treating patients with Ascaris lumbricoides infection.

Background:

Meta-analysis is a statistical technique in which the results of two or more independent studies, with similar objectives, are mathematically combined in order to improve the reliability of the results. The outliers, which may exist even in random models, can affect the validity and strength of meta-analysis results.

Meta-Analysis;Albendazole;Outliers;Random Effects Variance Shift Model;Ascaris lumbricoides Meta-Analysis;Albendazole;Outliers;Random Effects Variance Shift Model;Ascaris lumbricoides http://www.ircmj.com/index.php?page=article&article_id=17648 Hamid Alavi Majd Hamid Alavi Majd Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Khadijeh Najafi Ghobadi Khadijeh Najafi Ghobadi Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2122707347 Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2122707347 Alireza Akbarzadeh Baghban Alireza Akbarzadeh Baghban Department of Basic Sciences, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Basic Sciences, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Nayebali Ahmadi Nayebali Ahmadi Department of Lab Sciences and Proteomics Research Center, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Lab Sciences and Proteomics Research Center, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Elham Sajjadi Elham Sajjadi Department of Hematology, Tarbiat Modares University, Tehran, IR Iran Department of Hematology, Tarbiat Modares University, Tehran, IR Iran
en 10.5812/ircmj.17256 Prevalence of Internet Addiction and Associated Factors Among Medical Students From Mashhad, Iran in 2013 Prevalence of Internet Addiction and Associated Factors Among Medical Students From Mashhad, Iran in 2013 research-article research-article Conclusions:

Although our study showed the prevalence of internet addiction was not more than other populations and universities, since the prevalence of internet addiction is rapidly increasing worldwide, this population might also be at risk of addiction. Thus, focusing on related factors can help us in designing more effective interventions and treatments for this susceptible group.

Results:

It was found that 2.1% of the studied population were at risk and 5.2% were addicted users. Chatting with new people, communicating with friends and families, and playing games were the most popular activities in these groups. The factors related to internet addiction included: male sex, stage of education, daily time spent on using internet, most frequent time of internet use, monthly cost of use, and tea consumption.

Background:

Problematic internet use is on the increase and has caused serious problems in many areas. This issue seems to be more important for medical students.

Materials and Methods:

A cross sectional study was conducted on 383 medical students of Mashhad in 2013. Four hundred participants were selected through two-stage stratified sampling method proportional to the number of students in each stage of education. Data Collection was done through using the Chen Internet Addiction Scale (CIAS) and a checklist of demographic details and characteristics of internet usage behavior.

Objectives:

This study was designed to explore the prevalence of internet addiction and its related factors among the students of Mashhad University of Medical Sciences.

Conclusions:

Although our study showed the prevalence of internet addiction was not more than other populations and universities, since the prevalence of internet addiction is rapidly increasing worldwide, this population might also be at risk of addiction. Thus, focusing on related factors can help us in designing more effective interventions and treatments for this susceptible group.

Results:

It was found that 2.1% of the studied population were at risk and 5.2% were addicted users. Chatting with new people, communicating with friends and families, and playing games were the most popular activities in these groups. The factors related to internet addiction included: male sex, stage of education, daily time spent on using internet, most frequent time of internet use, monthly cost of use, and tea consumption.

Background:

Problematic internet use is on the increase and has caused serious problems in many areas. This issue seems to be more important for medical students.

Materials and Methods:

A cross sectional study was conducted on 383 medical students of Mashhad in 2013. Four hundred participants were selected through two-stage stratified sampling method proportional to the number of students in each stage of education. Data Collection was done through using the Chen Internet Addiction Scale (CIAS) and a checklist of demographic details and characteristics of internet usage behavior.

Objectives:

This study was designed to explore the prevalence of internet addiction and its related factors among the students of Mashhad University of Medical Sciences.

Internet;Prevalence;Students Internet;Prevalence;Students http://www.ircmj.com/index.php?page=article&article_id=17256 Maryam Salehi Maryam Salehi Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Research Center for Patient Safety, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Research Center for Patient Safety, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Mina Norozi Khalili Mina Norozi Khalili Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Seyed Kaveh Hojjat Seyed Kaveh Hojjat Department of Psychiatry, North Khorasan University of Medical Sciences, Bojnurd, IR Iran; Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, IR Iran; Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, IR Iran. Tel: +98-5842230783 Department of Psychiatry, North Khorasan University of Medical Sciences, Bojnurd, IR Iran; Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, IR Iran; Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, IR Iran. Tel: +98-5842230783 Mahta Salehi Mahta Salehi School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Ali Danesh Ali Danesh School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
en 10.5812/ircmj.14119 The Voluntary Response Index in Electromyographic Study During Landing Test of the Patients With ACL Deficiency: A New Study Protocol The Voluntary Response Index in Electromyographic Study During Landing Test of the Patients With ACL Deficiency: A New Study Protocol research-article research-article Background:

Daily Increased rate of anterior cruciate ligament (ACL) injuries in athletes calls for more investigation in these patients to differentiate copers from noncoper ACL-deficient (ACLD) knees as soon as possible.

Objectives:

The current study aims to introduce a new electromyographic protocol, named voluntary response index (VRI), that might help to categorize and differentiate patients with ACLD knee from others in the early stage.

Materials and Methods:

Thirty-four patients with ACLD knee were allocated into two equal groups, namely, coper and noncoper groups, based upon their ability to return to sport during the preceding six months. The patients with ACLD knee were asked to perform a jump on a force platform from a 75-cm distance.

Results:

The results were compared with 17 matched healthy participants. The electromyographic disposable electrodes were attached to the seven muscles of the lower extremity of the participants before performing the test. The outcome measures were the magnitude and similarity index of the VRI, time to stop, vertical ground reaction force, the displacement of the center of pressure’s (COP) path line length, and the participants’ Tegner, IKDC (International Knee Documentation Committee) as well as KOOS (Knee injury and Osteoarthritis Outcome Score) questionnaires scores. Using the appropriate statistical analysis, the electromyographic and force plate data were compared among the three groups. All efforts went into determining whether an association exists between the findings of each group and the participants’ functional questionnaires scores.

Conclusions:

The results of this study would be helpful in objectively differentiating the patients with ACLD knee into coper and noncoper groups to receive appropriate treatments before their return to the competitions.

Background:

Daily Increased rate of anterior cruciate ligament (ACL) injuries in athletes calls for more investigation in these patients to differentiate copers from noncoper ACL-deficient (ACLD) knees as soon as possible.

Objectives:

The current study aims to introduce a new electromyographic protocol, named voluntary response index (VRI), that might help to categorize and differentiate patients with ACLD knee from others in the early stage.

Materials and Methods:

Thirty-four patients with ACLD knee were allocated into two equal groups, namely, coper and noncoper groups, based upon their ability to return to sport during the preceding six months. The patients with ACLD knee were asked to perform a jump on a force platform from a 75-cm distance.

Results:

The results were compared with 17 matched healthy participants. The electromyographic disposable electrodes were attached to the seven muscles of the lower extremity of the participants before performing the test. The outcome measures were the magnitude and similarity index of the VRI, time to stop, vertical ground reaction force, the displacement of the center of pressure’s (COP) path line length, and the participants’ Tegner, IKDC (International Knee Documentation Committee) as well as KOOS (Knee injury and Osteoarthritis Outcome Score) questionnaires scores. Using the appropriate statistical analysis, the electromyographic and force plate data were compared among the three groups. All efforts went into determining whether an association exists between the findings of each group and the participants’ functional questionnaires scores.

Conclusions:

The results of this study would be helpful in objectively differentiating the patients with ACLD knee into coper and noncoper groups to receive appropriate treatments before their return to the competitions.

Anterior Cruciate Ligament (ACL);Coper;Voluntary Response Index (VRI) Anterior Cruciate Ligament (ACL);Coper;Voluntary Response Index (VRI) http://www.ircmj.com/index.php?page=article&article_id=14119 Amin Norouzi Fashkhami Amin Norouzi Fashkhami Physiotherapy Department, Shahid Behehshti University of Medical Sciences, Tehran, IR Iran Physiotherapy Department, Shahid Behehshti University of Medical Sciences, Tehran, IR Iran Abbas Rahimi Abbas Rahimi Physiotherapy Department, Shahid Behehshti University of Medical Sciences, Tehran, IR Iran; Shahid Behehshti University of Medical Sciences, Opposite to Bou-Ali Hospital, Damavand Avenue, Tehran, IR Iran. Tel: +98-2177561721; Ext: 4. Fax: +98-2177561406 Physiotherapy Department, Shahid Behehshti University of Medical Sciences, Tehran, IR Iran; Shahid Behehshti University of Medical Sciences, Opposite to Bou-Ali Hospital, Damavand Avenue, Tehran, IR Iran. Tel: +98-2177561721; Ext: 4. Fax: +98-2177561406 Khosro Khademi Kalantari Khosro Khademi Kalantari Physiotherapy Department, Shahid Behehshti University of Medical Sciences, Tehran, IR Iran Physiotherapy Department, Shahid Behehshti University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.8443 Maternal Quality of Life During the Transition to Motherhood Maternal Quality of Life During the Transition to Motherhood research-article research-article Background:

One of the elements of the broadening focus of health care beyond its traditional and restricted concept has been the increasing adoption quality of life approach to health care research and practice.

Objectives:

To investigate the QOL of women in the third trimester of pregnancy and at 8 weeks postpartum and factors associated with the overall QOL.

Materials and Methods:

Three hundred and fifty seven pregnant women attending urban health centers in Shahroud city, located in Northeast of Iran, completed the World Health Organization Quality of Life questionnaire (WHOQOL)-BREF and General Health Questionnaire (GHQ28) in the third trimester of pregnancy and at 8 weeks postpartum. Also, breastfeeding difficulties were assessed at 4 weeks postpartum. Statistical analysis was performed using SPSS 18 for descriptive statistics, paired t-test, linear regression and multiple regression analysis.

Results:

There were significant differences between the ante-and postnatal periods in mean scores in the physical (P < 0.001) and social relationship (P = 0.033) aspects of QOL. Multiple regression analysis revealed that factor adversely affected the global score of the QOL in the antenatal period was antepartum psychological disorders. Factors that adversely affected the global score of QOL in the postnatal period were postpartum psychological disorders, breastfeeding difficulties, multiparity, higher pregnancy weight gain, and cesarean.

Conclusions:

Results indicated that in this low risk group of women physical health and social relationship improved from pregnancy to postpartum. Interventions to promote psychological status during pregnancy and early postpartum should be designed.

Background:

One of the elements of the broadening focus of health care beyond its traditional and restricted concept has been the increasing adoption quality of life approach to health care research and practice.

Objectives:

To investigate the QOL of women in the third trimester of pregnancy and at 8 weeks postpartum and factors associated with the overall QOL.

Materials and Methods:

Three hundred and fifty seven pregnant women attending urban health centers in Shahroud city, located in Northeast of Iran, completed the World Health Organization Quality of Life questionnaire (WHOQOL)-BREF and General Health Questionnaire (GHQ28) in the third trimester of pregnancy and at 8 weeks postpartum. Also, breastfeeding difficulties were assessed at 4 weeks postpartum. Statistical analysis was performed using SPSS 18 for descriptive statistics, paired t-test, linear regression and multiple regression analysis.

Results:

There were significant differences between the ante-and postnatal periods in mean scores in the physical (P < 0.001) and social relationship (P = 0.033) aspects of QOL. Multiple regression analysis revealed that factor adversely affected the global score of the QOL in the antenatal period was antepartum psychological disorders. Factors that adversely affected the global score of QOL in the postnatal period were postpartum psychological disorders, breastfeeding difficulties, multiparity, higher pregnancy weight gain, and cesarean.

Conclusions:

Results indicated that in this low risk group of women physical health and social relationship improved from pregnancy to postpartum. Interventions to promote psychological status during pregnancy and early postpartum should be designed.

Quality of Life;Postpartum Period;Pregnancy;Women Quality of Life;Postpartum Period;Pregnancy;Women http://www.ircmj.com/index.php?page=article&article_id=8443 Forough Mortazavi Forough Mortazavi School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, IR Iran School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, IR Iran Seyed Abbas Mousavi Seyed Abbas Mousavi School of Medicine, Golestan University of Medical Sciences, Gorgan, IR Iran; Research Center of Psychiatry, Golestan University of Medical Sciences, 5 Azar Hospital, 5 Azar St, P.O.Box: 4916936175, Gorgan, IR Iran. Tel: +98-1714446070, Fax: +98-1714460008 School of Medicine, Golestan University of Medical Sciences, Gorgan, IR Iran; Research Center of Psychiatry, Golestan University of Medical Sciences, 5 Azar Hospital, 5 Azar St, P.O.Box: 4916936175, Gorgan, IR Iran. Tel: +98-1714446070, Fax: +98-1714460008 Reza Chaman Reza Chaman Department of Community Medicine, School of Medicine, Yasuj University of Medical Sciences, Yasuj, IR Iran Department of Community Medicine, School of Medicine, Yasuj University of Medical Sciences, Yasuj, IR Iran Ahmad Khosravi Ahmad Khosravi Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IR Iran